Stephen Hammond: I am grateful for that reply and I am sure that the whole House would wish to send our good wishes to Mr. Hamilton. Despite the lengthy reform review of Sport England, it has just suffered a £56 million cut, which the chairman, Mr. Mapp—the Minister's lifelong friend—said was a cut too far anda true loss to community sport. He also seriously questioned the legacy from the 2012 Olympics. Does the Minister disagree with his lifelong friend?

Richard Caborn: It is unfortunate that the hon. Gentleman gives only half the story. When I spoke to the Federal Sports Minister in Australia a few months ago, he was very envious of what we have been able to do in our schools in terms of participation. In 2001, some 2 million kids were doing two hours of quality physical activity or sport a week. Today, there are5 million. That is 6 million hours every week done by our children in our schools, and that is linked to the two extra-curricular hours.
	What the hon. Gentleman does not say about lottery money is the contribution that has been made by the new opportunities fund of £0.75 billion which has facilitated more than 2,000 refurbished or newly built sports facilities up and down the country. The hon. Gentleman should give the whole picture, not partof it.

Adrian Sanders: Apart fromthe Government's proposals for casinos, which will obviously increase costs in local communities, with increased crime and increased gambling addiction, what other plans do they have for the regeneration of coastal resorts?

Jo Swinson: I thank the Secretary of State for her reply. Obviously, we all want the Olympics to leave a positive legacy for sport in our communities, but Sport Scotland has reported that the recent spiralling costs of the Olympics will lead to a further £7.3 million cut in funding for grassroots sport in Scotland. How canthe Secretary of State talk about real benefits fromthe Olympics for grassroots sport when owing to her budgeting incompetence grassroots sport will face real cuts?

Stephen Hepburn: Will the Secretary of State pay tribute to those unsung heroesin sport—namely, local volunteers such as my constituent, Martin Devlin, whose boxing gym is bursting at the seams? Would it not be ironic if the greatest sporting spectacle that this country will ever have seen—the Olympics—were to deprive that boxing gym of its much needed extension? Will the Secretary of State meet me to discuss the matter further?

Maria Miller: Essential local services in my constituency, such as NeighbourCare and Speakeasy Advocacy, provide important and fundamental services to the elderly and people with learning difficulties, but they are already finding it difficult to secure lottery funding. What assurances can the Secretary of State give me and the people of Basingstoke that that situation will not get worse if there are further miscalculations about how much the Olympics willcost us?

Tessa Jowell: There have been no miscalculations about how much the Olympics are going to cost. The budget has been set and it will be kept to. I would say to the hon. Lady that it is completely unrealistic to ask for the sort of categorical assurance that every single lottery application will be met. It depends on whetherit meets the criteria for the lottery distributors and so forth. What the Government have done is to assemble an Olympic budget that will stand the test of time and deliver a legacy for this country. What we have not yet heard is what the Opposition's alternative might be.

David Clelland: I hearwhat my right hon. Friend says about lottery-funded schemes, but will she comment on the suggestion that Sport England is to divert £26 million from the sort of schemes mentioned by my hon. Friend the Member for Jarrow (Mr. Hepburn) into the Olympics? Can she give us the same sort of reassurance on that front?

Don Foster: Between now and 2012, the total cut in the lottery funding budget for grass-roots sports amounts to nearly £500 million. How does the Secretary of State square that with seeking to persuade the House that there will not be a reduction in participation for grass-roots sports? The Minister for Sport may say that Mr. Derek Mapp, who has been much quoted already, is wrong to suggestthat the cut to Sport England is a cut too far. Is the Secretary of State therefore surprised that Sport England is now reducing its target for people participating in sport by nearly 200,000?

Tessa Jowell: I simply do not recognise the claimof a cut of £500 million. That is the kind of financial probity that we have come to expect from the Liberal Democrats, which is why I am afraid that —[ Interruption. ]

Lynda Waltho: Although I welcome my right hon. Friend's assurances so farabout current budgets, I received over the Easter recess several lobbies from grass-roots sports clubs, so the message is not getting through—something encouraged in some cases by what one might call mischievous local election candidates. Will she consider giving a written assurance or a co-ordinating body an assurance, so that local organisations will get the message properly?

Tessa Jowell: The Olympic Delivery Authority will publish its budget, which will be set out in full. At every turn, as the hon. Gentleman knows, the Government have been open and transparent in ensuring thatthe Opposition have access to the figures and, as importantly, that Londoners and people who will be affected also have access to them.

Tessa Jowell: As my hon. Friend knows, we expect to make a formidable and very important bid, and we will do precisely the same if it is one for Glasgow as wedid for the Commonwealth games for Manchester. Of course, as I have said many times from the Dispatch Box, it is absolutely vital that we ensure that the whole country has the opportunity to benefit, as the people of the country have given such strong support for the Olympics.

Paul Beresford: The Minister may be aware that my constituency is rural and semi-rural. There are 32 villages. Most have their own halls. Most of those are charities. None has a record of disorderly behaviour at any of its functions. The halls are run for charity and they—particularly the little halls—have been severely hit by the legislation.In his review, will he consider taking some of this heavy-handed legislation off those little village halls, perhaps starting with a de minimis level below which the legislation need not apply?

Richard Caborn: I do not think that we need a royal commission; we just need some common sense in the game. In rugby union, rugby league and cricket, do we get the professional players or the managers arguing about the officials in those sports? No, we do not. I thought that it was time to write to the chairmen—the chairpersons, I should say, because I think that there was one lady among them.  [Interruption.] If they were all chairmen, I would call them chairmen. On thevery point raised by the hon. Member for Colchester (Bob Russell), I raised with the managers the issueof bringing back that type of discipline. Without mentioning one or two clubs in the premier league, there are some—

Barbara Keeley: A recent report told us that schoolgirls as young as nine or 10 have given up all playground activity, including football and other games. We are not sure whether that is because of role models and the behaviour that has been mentionedby hon. Members, but the lack of physical activity undertaken by girls of that age should concern us all. Will my right hon. Friend take up the lack of activity at school among girls as young as nine and 10, and see what can be done to increase their activity in games at school?

David Lammy: Therole of culture in regeneration has recently been strengthened by a joint agreement signed by the Department for Culture Media and Sport, the Department for Communities and Local Government and a number of non-departmental public bodies.

Norman Baker: I cannot say that I am surprised by that response, but will the Minister explain whatthe logic is of the BBC World Service radio programmes—I understand that there is now some television, too—being funded through a Foreign and Commonwealth Office grant? I recognise the great value of the BBC World Service to this country, but BBC World, which after all uses the growing medium of television rather than radio, is not funded in that manner. Is that not an anachronism that ought to be sorted out?

Andrew MacKay: Ifshe will make a statement on the Government's international summit on remote gambling.

Richard Caborn: Irrespective of the taxation issue,that international conference was attended by representatives from 35 jurisdictions, because of the very issues raised by the right hon. Member. It is true that it is not an easy issue, but at the conference, for which we called because of the problems of internet gambling, we agreed that we should have a framework of international regulation and governance that begins to address the three principles that I outlined. Irrespective of where the operation is, and in whatever country, it is important that people sign up to that charter, and that is what we are trying to achieve.

Peter Viggers: The Electoral Commission and the Hansard Society have recently publishedthe results of their fourth joint audit on political engagement. However, the hon. Lady will know that the Speaker's Committee has no role or duty to make a specific assessment of that or of other recent work undertaken by the Electoral Commission on political engagement.

Peter Viggers: Yes; the commission informs me that it has enjoyed significant success in increasing young people's interest in politics through activities suchas advertising campaigns, educational resources, workshops and a grant programme. An independent survey of 18 to 24-year-olds found that 52 per cent. of them had seen the commission's 2006 local elections campaigns, and 24 per cent. claimed to have voted because of them.

David Taylor: Will my hon. Friend say whether he thinks that consultation should take place directly with cathedrals, such as St. Martin's in Leicester? I agree with the hon. Member for Lichfield (Michael Fabricant) that thereis a deal of unease that the proposals might weaken the way in which that cathedral has developed its community role in such a magnificent fashion in the past two decades.

Stuart Bell: I am grateful to the hon. Gentleman for referring to music. One of the great features of my visits to Lichfield cathedral is listening to the music, and many cathedrals are renowned for their music.We often discuss the importance of our outstanding cathedrals and their ministry to the whole nation. This House pays tribute to the cathedrals, to their music and to all that goes on within their precincts.

Stuart Bell: The clergy working group, on which the Church of England was represented, produced a statement of good practice setting out minimum standards forthe terms and conditions of service for ministers of religion. The Church of England has committed itself to those principles and the General Synod has drafted legislation that has been sent to DTI officials, with whom we regularly communicate.

Ben Chapman: Even accepting that the wheels of the Church grind slowly, does my hon. Friend agree that, given that we have been talking about this for some10 years, it needs to move more quickly than it has? In so far as he can, will he encourage, through the clergy working group, other churches with similar problems to move equally quickly?

Bob Spink: What plans the Electoral Commission has to exercise the powers given to it under the Electoral Administration Act 2006 toset and monitor performance standards in electoral services.

Peter Viggers: The commission informs me that it has no powers to compel performance improvement. Its powers are restricted to setting the standardsand requesting information in order to measure performance against the standards. To put that in context, the Audit Commission has no powers to enforce particular regulations on local authorities; it does it by example. The Electoral Commission feels that it has sufficient authority to raise standards among electoral registration officers.

Simon Hughes: Will the hon. Gentleman discusswith his colleagues on the Speaker's Committee andthe Electoral Commission the proposal that is on the agenda to bring under one umbrella somewhere the review of all the boundaries of parliamentary constituencies for Westminster in Northern Ireland, Scotland, England and Wales, in order to ensure that whatever way people vote and whatever constituency they are in, the same criteria apply across the country, and above all that votes are worth the same because the constituency quota is the same whether in Scotland, Wales, England or Northern Ireland?

Mr. Speaker: Order. It is unfair to the hon. Gentleman for hon. Members to make so much noise. I ask them to be quiet. There are only a few minutesto go.

Stuart Bell: That is of course a matter for the House authorities, not for me. I would, however, say that the regulations contain a set of exceptions for religious organisations, broadly equivalent to thosein the Equality Act 2006, and it is for individual parishes to decide whether to take advantage of those exceptions.

Des Browne: With permission, Mr. Speaker, I should like to make a statement about operational events over the recess.
	Before I start, I know that the whole House will want to join me in expressing my condolences to the families and friends of the nine servicemen and women who have lost their lives since the House last sat.
	On 1 April Kingsman Danny Wilson and on 2 April Rifleman Aaron Lincoln were killed by small arms fire while on patrol in Basra city. On 5 April Second Lieutenant Joanna Yorke Dyer, Corporal Kris O'Neill, Private Eleanor Dlugosz, Kingsman Adam Smith and their interpreter were killed when their Warrior vehicle was hit by a massive bomb west of Basra city. On13 April Private Chris Gray was killed in Afghanistan in a firefight with the Taliban, and on Saturday night two servicemen were killed when two UK helicopters collided north of Baghdad. An investigation is ongoing, but all the evidence so far indicates that that was an accident, not an attack.
	Several personnel were seriously injured over that period in those and other incidents in Iraq and Afghanistan and they, too, are in our thoughts. That is a reminder of the risks faced every day by our forces on our behalf. I offer our gratitude and profound respect for those who have died and those who have been injured in the service of their country.
	I am sure that the House will wish me in the time available to focus on the incident that has attracted the most public and parliamentary attention over the recess, namely the incident in which 15 of our personnel were captured and detained by the Iranians, and the events that followed. I will describe, first, the incident itself; secondly, how it was handled diplomatically; and thirdly, how it was handled in media terms, including the decision to allow serving personnel to talk to the media individually and to accept payment for so doing—decisions for which, as I have already made clear, I accept responsibility. Finally, I will set out how we intend to learn the lessons for the future.
	Let me first turn to the incident itself. On 23 March HMS Cornwall was operating as part of the Coalition Task Force in the northern Arabian gulf, under the authority of a UN resolution. The task force is responsible for a range of maritime security operations, including protecting the Iraqi oil infrastructure and undertaking boardings to disrupt weapons smuggling.
	At 07.53 Cornwall launched two boats, with a Lynx helicopter in support, with the intention to board MV Tarawa, a merchant vessel that had evaded a boarding the day before. En route, the Lynx flew over a different vessel, MV al-Hanin, and reported a suspect cargo. A decision was made to board the al-Hanin. The position was well inside Iraqi waters.
	The boarding team boarded the vessel and, at 08.46, the Royal Marine boarding officer reported the ship secure. The Lynx was tasked to return to Cornwall. By 09.00 the helicopter was back on board and put at30 minutes' notice to fly.
	At 09.04 one of the two Royal Navy boats reported Iranian Revolutionary Guard navy activity nearby. Very soon afterwards, one of the boats reported that the Iranians were "beside them". By 09.06 voice communications with the boats were lost, and shortly after, all communications were lost. At 09.28 the Lynx was launched again and returned to the position of the al-Hanin. Initially it was unable to find the UK boats but at 10.05, one was spotted being escorted by Iranian vessels.
	That concludes what I can say about the operational details. I am happy to answer questions, but there is not much more to say at this stage, until investigations are complete. I will say two final things. First, the Royal Navy is not currently conducting boarding operations, although coalition partners are, and the Navy continues to fulfil its other tasks. Secondly, I support the decision of the Royal Marine captain to order his boarding party to lower their readied weapons. As he put it, he judged that, if they had resisted,
	"there would have been a major fight, one we could not have won, with consequences that would have had major strategic impact".
	Let me turn now to the diplomatic handling of the incident. The Iranians detained our personnel illegally, taking them first to an Iranian Revolutionary Guard naval base, and from there to Tehran. We made it clear, both directly to the Iranians and in public statements, that their detention was unacceptable and that they should be released immediately. We made intense diplomatic efforts to establish direct lines of communication with Iranian leaders, to prevent the situation from escalating and to resolve it quickly. It became clear that this alone would not be enough, not least because of the internal struggles within Iran asto who had control of the situation. We therefore galvanised the international community to put pressure on the Iranian regime. The Prime Minister has rightly paid tribute to those friends in the EU, in the UN, and in the region who supported us and condemned the illegal detention. I am in no doubt that this focused minds at the top of the Iranian regime.
	Our personnel were released on Wednesday 4 April, after a predictable attempt by the Iranian President to turn it into a propaganda victory. But this should fool no one. Serious observers do not believe that Iran has emerged from this in a stronger position, and we should remember that our main objective—the peaceful resolution of the incident and the safe return of our people—was achieved, earlier than many predicted. And let me be clear: there was no apology, and there was no deal.
	Let me turn now to the media handling of this incident. On Thursday 5 April, the 15 personnel arrived in the UK, and were debriefed and reunited with their families. The next day, six of the 15 held a collective press conference, organised by the MOD, which was uncontroversial. The controversy surrounds the relations between individual personnel and the media. The media had approached the families of the detainees while they were still being held in Iran. There were many offers of payment. These approaches intensified as soon as the 15 were released, and it was clear that the pressure would soon be transferred from the families to the individuals themselves. They were already aware of the criticism of their behaviour while detained, and some were intent on setting the record straight.
	This left us with a dilemma. We had a duty of care to the individuals and their families, who were under intense pressure. On the Thursday, all those involved took the view that we should allow the individuals to talk to the media, and that we should support them through that process. I believe that all those involved in this decision acted in good faith and out of a desire to protect the individuals, to protect the service, and to protect operational security against the risks inherent in unofficial dialogue with the media. These were real risks, which have materialised in the past.
	Once the decision had been taken to allow the individuals to talk to the media, this raised a second question: how to handle the fact that the media were competing for these individuals by offering substantial sums of money. This second question was considered by the Navy over the same short period. The Navy concluded that payments were "permissible" under Queen's Regulations, and that in this particular situation it was "impractical to attempt to prevent" them. This was the position presented to me in a note sent from the Navy's HQ in Portsmouth to my office on Thursday afternoon, and which was put to me on Good Friday. I accept in retrospect that I should have rejected the note and overruled the decision. The circumstances were exceptional, and the pressure on the families was intense. The Navy's decision was made in good faith, and so was its interpretation of the regulations; but I should have foreseen that that attempt by the Navy, in good faith, to handle an exceptional situation would be interpreted as indicating a departure in the way in which the armed forces deal with the media.
	Over the weekend I discussed the issue further, and on Monday I asked for further advice from naval chiefs and the Chief of the Defence Staff. I decided that we must review the rules immediately, and stop any further media payments to serving personnel until the review was complete. I informed the Prime Minister—which, as he has made clear, was his only involvement in this matter—and announced the decision in a statement.
	Let me be clear to the House: I made a mistake. I have been completely open about that. To the extent that what happened between Friday and Monday has caused people to question the hard-won reputation of the armed forces, that is something I profoundly regret; but I remind people that precisely because that reputation is hard won, it is not easily undermined.
	Those are the facts as I know them. Let me now turn to what happens next. I made clear on Monday the implications for the specific issue of serving personnel receiving payment—I made it clear that it must not happen again—but clearly there are other lessons to be learned from the whole incident.
	The first aspect relates to the operational circumstances and factors leading to the capture of the 15 personnel. This was an unusual situation with wide and far-reaching consequences. To reflect that, I can announce that the Chief of the Defence Staff has appointed Lieutenant-General Sir Rob Fulton ofthe Royal Marines, currently the Governor and Commander in Chief of Gibraltar, to lead an inquiry. As a retired former commander of UK amphibious task forces, he will bring both expertise and objectivity to the inquiry.
	The inquiry will cover all operational aspects, including risk and threat assessment, strategic and operational planning, tactical decisions, rules of engagement, training, equipment and resources. I expect it to take around six weeks. Clearly those conducting the inquiry will consider operationally sensitive material and it will therefore not be possible to publish all the conclusions, but they will be presented to the House of Commons Defence Committee in full. I am committed to ensuring that Parliament and the public have the full facts, but also—which is just as important—to ensuring that the Ministry of Defence and the services learn from these events and do not let this happen again.
	In a similar spirit and in the same time frame, I can also announce that I will be asking a small team to take over the review of the media handling which I started last week. The team will consist of a senior officer and a senior MOD official, both unconnected with these events, and will be led by an independent figure with wide media experience. The review will draw on all relevant experience, not just this particular incident but other high-profile incidents involving personnel on operations.
	I want to make it clear that the review is not a witch hunt. As I have already said, I take responsibility for this particular case. Rather, the review will seek to identify lessons and make recommendations on how to manage the complex issues involved. It will make recommendations on how to balance our duty to support our people with our duty of transparency, our duty to protect the reputation of the services and, most important, our duty to protect the security of our personnel in a demanding media environment.
	I take responsibility for what happened last weekend. I have acted to put it right. I have acted to ensure that we learn the lessons of the whole episode, in a manner that allows full parliamentary scrutiny. As we go through that process, we should remember the most important point—which is that we got our people back safe, and on our terms.

Liam Fox: Let me begin by fully associating the official Opposition with the sentiments expressed by the Secretary of State about the nine servicemen and women who died serving our country. Our thoughts and prayers will be with their friends and families, and the whole country should be proud of and grateful to them.
	I welcome the Secretary of State's statement, but like all Members, I deeply regret the circumstances that made it necessary. The statement goes to the very heart of our democratic system, because it poses the question "What are politicians responsible for?".
	No one expects the Secretary of State for Defence to have day to day knowledge, far less management, of naval manoeuvres in the Persian gulf, but the wider picture is a different story. It is only three years since naval personnel were illegally abducted by Iranian forces. It should never have been allowed to happen again, especially as the threat from an ever-more belligerent Iranian regime has increased rather than decreased.
	How can it be that the incursion of Iranian forces was not detected by air or by the ship's radar? If it was detected, why was it not communicated to our sailors and marines? If communications were lost at 09.06, as the Secretary of State said, why did it take until 09.28 for the Lynx helicopter to be relaunched? Perhapsmore importantly, do we even have the right naval configuration now in the northern gulf? If the northern waters are too shallow for HMS Cornwall and we if we still need to protect Iraqi oil installations and carry out searches on shipping in the gulf, should we not have more, smaller vessels to supplement the activity and properly protect our personnel?
	I note that there are other countries continuing their UN duties of searching shipping in the gulf. I believe that the decision to stop the Royal Navy boarding shipping in the light of this incident sends exactly the wrong signals about our resolve and intention.
	We welcome the announcement of an inquiry, but we want an assurance that there will be a chance for the whole of the House of Commons to debate its broad findings, not just the Defence Committee, for this is an issue of great national importance. As the shadow Foreign Secretary said yesterday,
	"It has undermined the reputation of our armed forces at home and abroad".
	Or, as  The Sunday Times put it,
	"Nations with unfriendly intentions towards Great Britain will have observed this latest episode with interest."
	Countries are inclined to take risks if they detect a lack of resolve. Does no one in the Government actually feel responsible for the national humiliation that we have suffered at the hands of the pariah regime of Iran?
	But even if Ministers do not feel responsible for that, they cannot avoid the direct responsibility for the second fiasco; the media handling of the return of the captives. The eventual return of the captives, welcome as it was, was not a shock and the shambles around the media handling is unforgivable. The Government initially excused the decision— [ Interruption. ]

Liam Fox: The Government initially excused the decision to allow stories to be sold on the basis that there was excessive media pressure and that stories would come out anyway. Yet we now know that the Press Complaints Commission offered to help the Government in preparation for this matter in advance but were snubbed by the Government. The Government initially told us, repeated by the Secretary of State today, that this was a decision for the Navy. But we know that that is not true. The Defence Council guidelines, published in 2004 after the death of David Kelly, state that for those seeking to deal with the media on national issues, authorisation should be obtained from the chief press officers in the directorate news organisation. Queen's Regulations clearly state:
	"Normally permission to express views on politically controversial issues will be refused. For any exceptions to this rule, the Director of Information Strategy and News will seek the prior approval of the Secretary of State for Defence."
	Queen's Regulations also state that
	"If there is insufficient time, the invitation should be refused."
	Does not that make a mockery of the Secretary of State's version of events? He says that he was asked to note the decision. The truth is that he is asked to make the decision, as Secretary of State. He said that, over the weekend, he was not content with the analysis and he did not think that the Navy was either. Given that neither was content with it, why did it take almost72 hours for the policy to change? The Secretary of State said previously that Downing street was not aware of the decision until the Sunday. Yet the Leader of the Opposition, the shadow Foreign Secretary and I were all aware on the Saturday. How can that be true? Is not the truth that the Secretary of State went back to his constituency without fully appreciating the importance of the decision he was making, and is not that the greatest indictment of all?
	What I find most unbelievable is that a decisionto allow stories to be sold could be taken without understanding the impact that that would have on the Army, the RAF and large parts of the Navy. For those in the Army in particular, which has taken the bulk of casualties and fatalities, to see unharmed naval colleagues profit financially caused anger, injury and offence. The hurt done to the families involved can only be guessed at. It was best summed up by the mother of one of those whose bodies were returned to the United Kingdom last week. She said:
	"If you are a member of the military, it is your duty to serve your country. You should do your duty and not expect to make money by selling stories."
	In a more honourable time in politics, the resignation of a Secretary of State who had overseen such a humiliating fiasco on his watch would have been an inevitability. The Secretary of State said that he took responsibility, but the word "sorry" never passed his lips. When Argentina invaded the Falkland islands25 years ago, no one believed that that was the fault of Lord Carrington. Yet he and his team resigned because it happened on their watch and they believed that the buck stopped with them. For them, that was a matter of honour.
	We have asked a number of detailed questions ofthe Secretary of State. On the basis of his statement today, I believe that his position is becoming untenableas he cannot command the necessary confidence in his political decision making. That confidence is essential to the belief, morale and strength of our armed forces. His colleagues must make their own judgments. Ultimately, so must he.

Des Browne: I thank the hon. Gentleman for his remarks in relation to those who have been lost while the House has been in recess. He speaks for all Members in what he says on that.
	Anybody who has been following the hon. Gentleman's comments over the past week could be forgiven for not being absolutely clear as to what his position is. Members will remember that initially he was accusing me of orchestrating this entire episodefor propaganda purposes. A couple of days later hewas complaining that precisely the opposite was the case—that I did not orchestrate the episode at all. Clearly, those claims cannot both be correct.
	Many things have been said and printed over the past week. Some of them have been true and some have been untrue, but I have made my position clear throughout. I have described to the House my involvement in this process—and, indeed, also the involvement of the Prime Minister. I have said that I made a mistake. If that caused people to question the hard-won reputation of the armed forces, I deeply regret that.
	It will, of course, always be the case that the hon. Gentleman will be able to find a word that I have not used, but it seems perfectly clear to me that I have expressed a degree of regret that can be equated with an apology and if he wants me to say "sorry" then I am happy to say sorry. It is possible to come up with any number of questions, but what is important is that we focus and learn from these circumstances. I intend to do that, and to get on with the job.
	The hon. Gentleman also questions whether I have the confidence of the armed forces. He and others will need to ask the armed forces that for themselves. I can say that they should do so because I have confidence as to the answer that they will receive.
	On operational issues, the hon. Gentleman raised a number of questions. In my statement, I made the point that because of operational security there is a limit as to how useful or appropriate it would be to debate such issues. In particular, he asked questions about why the UK has not recommenced boarding operations. Currently, advice is awaited from PJHQ—permanent joint headquarters—as to where, when and how those operations will be recommenced, and until I receive that advice, no decision can be made.
	On the other issues raised, I suggest that they are precisely those that the inquiry should, and will, look at. I hope that Members were clear from the description in my statement that this inquiry has the right scope and is led by an officer with the right expertise and objectivity to ensure that the issues are looked into properly, to ensure that Parliament gets the answers it deserves and, most importantly, to ensure that we learn the lessons for the future.

Nick Harvey: I thank the Secretary of State for his statement and for notice of it. I echo his words of condolence in respect of the nine servicemen who have lost their lives and those who have been injured. The media coverage of this sorry affair has been a national embarrassment and the judgment that it would be right to allow those people to sell their stories has hardly been vindicated by the sort of reports that we have seen of one in particular complaining that he had had his iPod taken away and that his Iranian captors had called him Mr. Bean. That is not something that has covered the nation in glory around the world. The House will note that the Secretary of State has accepted some responsibility for those judgments.
	The greater issues that need attention, and the questions that need to be asked now, relate not to the media coverage but to the original incident itself. Why was there inadequate cover? Why did the helicopter go back to the boat? Why, given that we are part of a coalition, were no other air assets available to help? Why were no other boats on hand? I understand that HMS Cornwall could not go in, but there are many craft between a RIB and HMS Cornwall. Why was no other support available in the sea? Following the previous incident, what sort of risk assessment had been made, and what lessons were learned?
	Those are the sort of questions that the Secretary of State tells us will be addressed by the inquiry. We note that that has been set up by the Chief of the Defence Staff and is to be conducted by a former head of the Marines. Would it not be a valuable addition to have some political input, perhaps from Privy Councillors with relevant experience in that area.
	It is those questions about what happened on23 March that need to be answered and which should determine the fate of the Secretary of State for Defence. It would not be right for him to resign his post over the media coverage of those events while the Prime Minister and Cabinet who led us into the most disastrous foreign intervention in 50 years remainedin post.

Des Browne: I do not intend to be drawn into a discussion that involves us sitting here, in the comfort of these Benches, and criticising the behaviour of young people whom we have asked to carry out a very dangerous job in dangerous circumstances—[Hon. Members: "Hear, hear."] The hon. Gentleman asks several very pertinent questions and he is right that those are just the questions that the operational inquiry will have to consider. If the hon. Gentleman wishes to suggest questions for the inquiry, I would welcome that. I can assure him, from my conversations with the chiefs of staff—and in particular with the Chief ofthe Defence Staff—that it is already the intention that the terms of reference of that inquiry will reflect the broad range of questions that the hon. Gentleman poses. In passing, I should say that we will publish the terms of reference of the inquiry once they are settled.
	The hon. Gentleman invites me to consider adding someone from a political background to Lieutenant-General Sir Rob Fulton, who is an eminently qualified person to carry out an operational inquiry, given his distinguished career in the Royal Marines and hisown significant experience of operations. That would be entirely inappropriate. It is important that the operational matters are investigated by and recommendations made by people with the appropriate experience and expertise to do that. I cannot think of anybody from a political background who would add anything to those necessary ingredients.

Gerald Kaufman: Since the shadow Secretary of State for Defence mentioned the offer from the Press Complaints Commission to advise the 15 young service people who were risking their lives for their country but were totally inexperienced in dealing with the press, canmy right hon. Friend say whether the PCC cited the example of a public servant—the chairman of the PCC—who as ambassador to Washington broke every rule in the book in selling his story to the press? There was no PCC investigation of that.

Des Browne: As I have already said, I do not intend, from the comparative comfort of this place, to get into criticising the way in which young people behaved in circumstances of which I have no experience. However, that said, I accept the broader points that the righthon. and learned Gentleman makes. I can assure him that all but one of the service personnel involved were given the appropriate training, as far as I am aware. I am advised that that is the case; all but one of themwas given appropriate training in how to conduct themselves in those circumstances. However, thepeople who debriefed the personnel, who have the interrogation expertise to make this judgment, have told me that in their view those young people deported themselves and behaved well within the bounds of appropriate conduct in the situation in which they found themselves. I am not in a position to make that judgment on their behalf, but I accept the judgment made by those with the expertise. In my view, there is no legitimate criticism to be made of those young people and I do not accept that the way in which they conducted themselves and the way in which they were opportunistically exploited by the Iranians for propaganda purposes causes any embarrassment to this country.

Des Browne: The specific support given to the families was the responsibility of the Royal Navy. Members will recollect that on the day the detainees were released, almost every single family expressed through the media its deep gratitude for the support received from the MOD and the Navy. These matters are continually kept under review to ensure that we are in a position to support families that find themselves in these very difficult circumstances. We can say with a degree of satisfaction that that part of the support passed without incident and certainly without controversy.
	My hon. Friend puts her finger exactly on oneof the complicating factors that created the difficult circumstances in which those who acted in good faith made the decision and interpretation of the regulations that they did. The view was taken—I understand this—that these stories would be told and that the likelihood was that they would be told in an uncontrolled environment where there would be some danger of risk to operational security. In my view, there can be no controversy about the decision to support the young people to tell their stories—just as the decision to support the young people who gave the press conference was the right decision to ensure that no operational risks would take place. The controversy arises from the issue of payment for those accounts of events, which is exactly what I have asked the review to look into. I will act on the recommendations of that review.

Elfyn Llwyd: On behalf of Plaid Cymru and the Scottish National party, I associate myself fully with the Secretary of State's expressions of condolence.
	Many of us believe that the Secretary of Stateshould have declined to accede to the MOD request immediately he received it. Does it not presuppose a problem with military discipline? Should he not have gone back to the top brass and told them to remind the young people of their obligations and order them not to speak to the media?

Des Browne: I have no evidence to suggest that the absence of that skill at that level in the command chain in the Navy contributed to the circumstances. It will, of course, be a matter that may come out in the review,in considering the support that individual servicesneed to support their people in this modern media environment. I have no intention of discussing the status of the Second Sea Lord. As far as I am concerned, today is about my accountability to Parliament, and I have accepted my responsibilities.

Paul Keetch: Is the decision to return the Lynx from the area of the boarding party the standard operational procedure for air supportfor such boarding operations? Why was HMS Cornwall—a batch 3 Type 22 frigate equipped to carry two Lynx helicopters—deployed in that war zone with only one Lynx helicopter?

Des Browne: I am grateful to my right hon. Friend for her opening remarks. I appreciate them greatly. Coming from her, they are all the more valuable to me. It is our intention to continue to make a contribution to the taskforce that carries out those maritime operations in the north Arabian gulf. I have visited one of our ships out there to see how important that work is. There has been a concentration on one aspect of their work in the House today, and understandably so, but substantially the Cornwall is there to protect a really important part of the Iraqi oil infrastructure: the oil terminal. That is why the Cornwall, and ships of that class, are the appropriate ships to be there: because of the nature of the work that they need to do. We should not forget that, on occasions, 85 per cent. of the GDP of Iraq comes out through that terminal. It is crucially important to the economic welfare and development of Iraq. It is not our intention to abandon that very important work that we presently carry out with the United States and the Australians, as well as with the Iraqis themselves.

Des Browne: I respect the hon. Gentleman's viewson these matters because of his experience in, and contribution to, our armed forces. He regularly engages with me on such issues and knows my commitment to ensuring that we live up to the undertaking of giving our commanders what they need to do the job on the ground. He also knows the advances that we have made in the past 12 months on getting additional protected vehicles in place, especially in southern Iraq. However, the experience of the attack on the Warrior makes it very clear that the type of device that is being deployed against our forces is such that it is unthinkable that we could find an armoured vehicle that would stand against that and with which we could do a job. As he knows, this is about not just vehicles, but tactics, intelligence and other operational requirements. As events over the weekend have shown, all those things have improved exceptionally in Basra. Our troops there are literally fighting back against the risks with significant success.

Alan Beith: Should the Secretary of State have been more mindful of the thousands of the people in the armed services, including special forces, and in the intelligence community who have to accept the discipline thatthey do not talk to the press about their work? Theyare helped in doing so if the rules are clear and undermined if stories are sold. There are many difficult decisions that the Secretary of State has to take, but surely, given the predictable outcome, this was not difficult.

Crispin Blunt: What we cannot escape is that we endured an operational humiliationat the hands of Iraq, followed by a self-inflicted humiliation for the reputation of the Royal Navy at the hands of its own board. These wretched events are symptomatic of a collapse of the covenant between the nation and its armed services. The Secretary of State must give serious consideration to whether in the present circumstances, having given the apology that he has given to the House, he is the right person to try to repair and put that covenant back together.

Des Browne: I accept my responsibility, but I say very clearly, as I have already done twice in the House, that I do not think that I or anybody else in the House should volunteer themselves into a situation in which they can condemn those young people for their behaviour, and for their exploitation in circumstances of which, as far as I am aware, nobody in the House has any experience at all. The hon. Gentlemanasks that I accept responsibility; I have accepted responsibility, and there is nothing belated about my doing so. I have nothing further to add in relation to the conduct of the young people involved.

Patricia Hewitt: With permission, Mr. Speaker, I should like to make a statement on the progress that we are making in relation to modernising medical careers. As I explained to the House in my written statement on 27 March, the independent review group continued its work over the Easter recess, which included making two important announcements to applicants for training places. Copies of those announcements are being placed in the Library today. The review group decided that it would be wrong to abandon the process of interviews now under way and concentrated instead on how to change the process in order to meet the needs of junior doctors and the NHS as a whole. Furthermore, it concluded that the problems that have arisen relate in the main to the implementation process, and not to the underlying principles of modernising medical careers.
	Following the review group's recommendations, recruitment to general practice training programmes, which has not generally given rise to problems, will continue as planned, although the timetable may need to be revised to make sure that it is co-ordinated with the revised timetable for other specialties. The review group is undertaking further work on recruitment to academic medical programmes, and it will make a further announcement on that shortly.
	On recruitment for speciality training, which is where most of the recent problems arose, the review group's statement on 4 April sets out the changes needed. The group's proposals have the support of the Academy of Medical Royal Colleges and the British Medical Association and are now being implemented by the NHS with the postgraduate deaneries. For applicants who have already been shortlisted, all interviews already conducted in round 1 will be honoured and the outcomes will count. Eligible applicants will also be able to revise their preferences later this week in the light of published competition ratios, and they will be offered an interview for their first preference post, if they have not already had one. Eligible applicants who were not previously shortlisted will also be able to revise their preferences and will be guaranteed an offer of an interview for their first preference.
	We expect job offers to begin to be made in early June, but not all jobs will be filled at that point. There will then be a second round of recruitment for applicants who do not get a job in the first round. That second round will be based on a revised short listing and interview process, which will include a structured CV.
	This has been a time of great distress for junior doctors and their families, and I apologise to them unreservedly for the anxiety that has been caused. I believe that we now have the right way forward for this year's recruitment to general practice and speciality training, and that applicants can be confident that they will be treated fairly. I want to record my thanks to Professor Neil Douglas and his review group for the very considerable amount of time and expertise that they have already contributed. They will continue their work and, as I have said previously, we will publish their final report. I want to thank, too, the NHS consultants and deaneries who are being asked to conduct a large number of extra interviews within a short space of time. We will keep the timetable under review. The Health Departments in the other home countries will be making their own announcements on the arrangements that apply there.
	Finally, the review group was set up to deal with this year's recruitment process. We are now some two years into the modernising medical careers programmethat began with the successful launch of foundation programmes in 2005. The time is now right to undertake a wider review, to clarify and strengthen the principles underlying MMC and to ensure that, where necessary, we make further changes for future years. Historically, Britain's medical education and training system has been rightly regarded as second to none. The creation of a competence-based training system that is widely accepted remains the right way forward, but all involved must be confident that the pursuit of excellence remains at the heart of the system. I am therefore establishing a second independent review to consider those and other broader issues. I am very pleased that Professor Sir John Tooke has agreed to chair the independent review. Sir John is dean of the Peninsula medical school, chair of the Council of Heads of Medical Schools and chair of the UK health education advisory committee. We are working withSir John on the terms of reference and membershipof the review, and I will make a further announcement shortly. Modernising medical careers is a UK-wide programme, so the devolved Administrations will be fully involved in the process. We will, of course, publish Sir John's report.

Andrew Lansley: I am grateful to the Secretary of State for her statement and for the chance to see it beforehand. I am glad that she volunteered a statement on this occasion, insteadof being dragged to the Chamber, as she was on19 March. She has had to eat three helpings of humble pie this afternoon—first, in making an apology, which she should have done on 19 March, but I am glad that she has done so now; secondly, in saying that at least in the second round of interviews there will be access to a structured CV, which, she maintained, would be truein the first round, when she spoke to the House on19 March; and, thirdly, in accepting the need for a further strategic review, which she has not been willing to concede previously.
	In her statement, the Secretary of State said that it was the implementation process that went wrong, not modernising medical careers itself. She is right that MMC has attracted support in principle, including from the Opposition, but questions about implementation were raised by the British Medical Association and the royal colleges, which she and her Department have overridden—if only she had listened. When Professor Alan Crockard resigned as national director of MMC he said that the medical training application service
	"was developed and procured by the Department of Health outside my influence."
	He went on to say:
	"From my point of view, this project"—
	namely, MTAS—
	"has lacked clear leadership from the top for a very long time."
	Subsequently, when Professor Shelley Heard resigned as the MMC national clinical adviser she said that the principles that the Secretary of State says have so much support
	"have been lost in the detail and acrimony of a recruitment process which should have supported and not driven it."
	There have therefore been two resignations by people who hold others responsible. Who, then, does the Secretary of State hold responsible?
	The way forward this year is still fraught with difficulty. Does the Secretary of State believe that it is sustainable to offer applicants up to four interviews in the first place, but to make them choose only one? She said that the second round will be based on a revised shortlisting and interview process, including a structured CV. Does that mean abandoning the absurd scoring system for shortlisting? Will interviewers in the first round have access to a full CV and references or, as I understand it, will the first interview still be conducted on the same basis as was first proposed, with all the attendant problems?
	Will the Secretary of State say how many posts will be available—18,500 have been loaded on MTAS so far, and there were originally 33,000 applications? What are the two respective figures now?
	Clearly, there were more applicants than the Department expected. On 19 March, I asked the Secretary of State whether she would create extra training posts by reclassifying trust grade posts. Will she now confirm that her Department has subsequently asked trusts to do as I proposed? And how many such posts is she willing financially to support?
	Will the Secretary of State ensure, not least by creating new training posts, that the lost tribe of senior house officers are not forced into a dead end? She must know that they were disadvantaged under the MTAS scoring system, and if they do not gain ST3 posts this year, they will be ineligible in future years. For example, she must know that 1,829 surgeons have been shortlisted for ST3 posts and that only 534 posts are available. Will the Secretary of State promise that they will be able to access training posts this year, even if only on a one-year basis, and that they will be eligible for run-through training posts next year and potentially the year after, so that there is a viable transition for them?
	Finally, I welcome Sir John Tooke's appointment to head a full review, which we also called for. It is time for the medical profession to reassert its responsibility for the education and training of future medics. MMC is needed to reflect a changed world in which trainees are no longer expected substantially to deliver NHS services, but the principle has been undermined by lamentable implementation. The Secretary of State and her Department must accept responsibility for that, and in the light of the appalling shambles that they have made of the situation, will she promise to listen and to let the medical profession give the lead in future?

Rob Marris: Last autumn, I wrote to the Secretary of State expressing concerns about this year's implementation. The reply from the then Health Minister, Lord Warner, indicated that my concerns were misplaced, so several weeks ago I wrote back to the Secretary of State's ministerial team pointing out that the implementation was not going well, to say the least, and askingwhether anyone responsible had been disciplined asa consequence. I have not received a reply to that question.
	I do not wish to know names. I do not wish to hear that the Department does not believe in a blame culture, because that would be avoiding responsibility. I do not wish to hear that it is time to move on. What I would like to know from the Secretary of State is whether any disciplinary proceedings are in train or concluded against anyone whatsoever for these problems; if so, how many; and if not, why not.

Patricia Hewitt: Modernising medical careers obviously does not affect nurses. It is perfectly true that some newly qualified nurses and other health care professionals have found it extremely difficult to get posts in the current year, given the financial difficulties that the NHS has had to grapple with over the past12 months, but we do not expect those problems to continue—certainly not on that scale—in future years. We are working with the newly strengthened social partnership forum to see, for instance, whether it might be possible to offer guaranteed employment in some cases to newly qualified health professionals.

Patricia Hewitt: I thought that that might be the hon. Gentleman's point and I was just about to say that in Wales the Assembly Government's Health and Social Services Minister announced £5 million additional recurrent funding for mental health services, to help implement the revised national service frameworkfor Wales, and an additional £75 million capital investment. That demonstrates the Assembly's commitment to improving standards in our mental health services.
	Of course there is more to be done: there always will be. But I pay tribute—as I hope we all would—to the outstanding care that is being given by NHS staff to extremely vulnerable and sometimes very difficult and challenging patients. That work is reflected in the fact that the number of suicides is at the lowest level since records began, and is among the lowest in Europe.

Patricia Hewitt: I completely disagree with the hon. Lady. Far from broadening the clinical definition of a mental disorder, what we are doing—by simplifying the definition of a mental disorder in the 1983 Act—is removing four legal categories that have no particular correspondence to clinical categories. The categories of definition of mental disorder in the 1983 act are not clinical, so by removing that confusion and having a single simplified definition we will ensure that people who need treatment in such circumstances will actually receive it. The Bill will bring the law into line with modern developments in mental health services, deal with human rights incompatibilities and strengthen patient safeguards.

Patricia Hewitt: I completely agree with my hon. Friend. Of course, we do not want to see young children treated in adult wards, but nor do we want to put clinicians into a kind of legal straitjacket that could have the wholly unintended result that a young person in desperate need of care is turned away because a child bed or a child ward is not available for them. In my view, we need to focus on continuing to improve the services we provide for children and adolescents rather than believe that simply making changes to the law will solve the problem.
	At the heart of the Bill are the provisions inchapter 4 for supervised community treatment. When the current law was introduced, the focus of care for people with the most serious mental health problems was in hospital, and the use of compulsion meant detention, and sometimes forced treatment, in hospital. Modern medicine and clinical practice has shifted the whole focus of care into the community and the law needs to follow. The Bill would, therefore, enable a patient who is detained in hospital to be released under supervised community treatment, enabling some patients to be discharged into the community earlier than would otherwise be the case—a real benefit for them and, often, for their carers, too.
	Those provisions, of course, are designed particularly for the so-called "revolving door patients"—people who are hospitalised, whether under compulsion or voluntarily, who respond to treatment, who are released, and who then fail to maintain their treatment, producing another crisis and yet another hospitalisation. That pattern features all too often when someone who has been in contact with mental health services takes their own life—some 1,300 people a year. The same is also true in many of the far smaller number of cases—about 50 a year—when someone else dies at the hands of a mental health patient. We will probably never be able to prevent every such death, but supervised community treatment is essential to help ensure that patients who have been discharged from hospital continue with their treatment in the community, helping to keep them well and thereby helping to protect them, their families and the wider public.

Patricia Hewitt: My hon. Friend makes an extremely important point about rights for victims in these tragic cases—a matter that the Minister of State, my right hon. Friend the Member for Doncaster, Central(Ms Winterton), will want to discuss with her and others so as to establish how best to proceed.

Tim Loughton: Can the Secretary of State nameone physical health condition to which similar circumstances currently apply?

Patricia Hewitt: Our estimate is several thousand, but, in any case, it is too many. I am afraid that there is a perverse incentive inherent in the treatability test—it is inherent in any test of the likely effect of treatment, rather than its purpose—for some patients to refuse to engage with treatment in the hope of proving that it will have no effect on their condition.
	The hon. Gentleman, who is muttering away on the Opposition Front Bench and clearly does not like my answer, needs to recognise that the treatability test is taken into account by the courts in sentencing offenders, as well as by clinicians in deciding whether detention is appropriate. I do not know whether he is aware of this, but let me refer the House to the case of a man called Richard Ley, who was sentenced to life imprisonment in 2005 for setting fire to his own flatin a suicide bid. The judge who sentenced him, Judge Sean Overend, said:
	"You were trying to self harm and did not care about the safety of others. I pass the life sentence with a heavy heart because it seems to me that to send you to prison for life when you have a disorder within the Mental Health Act is an inept disposal. But it is forced on the court because the consultant psychiatrist says that your personal disorder is untreatable so I cannot make a hospital order."
	That is precisely what is wrong with the treatabilitytest.  [ Interruption. ] I do not know why Opposition Front-Bench Members seem to think that this is a matter for laughter. It was a tragic case. Modern clinical practice is that treatment is possible for people with personality disorders. The current combination of the four different categories of mental disorder—which we are going to get rid of—and the misunderstanding or current interpretation of the treatability test is having precisely the wrong effect.

Patricia Hewitt: The hon. Gentleman is quite right that we have to look both at the treatability test and the definition of mental disorder. As I have indicated, we propose to change both. But I do not accept his point that, in the light of the changes that we wish to make to the definition of mental disorder, we can therefore be comfortable with retaining the treatability test. The way in which it has been defined in the amendment made in another place would have thoroughly unhelpful—and in some cases, quite disastrous—consequences, of the kind that he describes in relation to, as I take it, one of his constituents.
	I am conscious of the fact that I have been generous in giving way and that there are many other hon. Members who wish to speak in the debate, so let me just turn briefly to the other key provisions in the Bill. I have referred already to the changes to the basic definition of mental disorder in the Mental Health Act 1983—as have others. We also intend to remove all the exclusions from the definition of mental disorder—except the one for alcohol and drug dependants—again in the belief that the simpler we can make the law, the fewer arbitrary obstacles there will be to the proper use of the legislation, thus ensuring that people who are seriously ill and need treatment get that treatment.
	The Bill will update legislation in line with new ways of working in health and social care. Many of the statutory functions under the 1983 Act have to be carried out by a psychiatrist or social worker. However, of course, the world has moved on. For example, nurses are now taking on a wider range of roles and gaining additional qualifications in a way that simply was not happening 20 years ago. The Bill thus opens up several such functions to people who have the right skillsand experience, regardless of their professional background. I know that those provisions have been warmly welcomed by the Royal College of Nursing, Unison and others.
	We will strengthen safeguards for patients who are subject to the compulsory powers of the 1983 Act. At the moment, all patients under compulsory powers have the right to apply to a mental health review tribunal. However, the Bill will establish a maximum period after which all civil patients must be referred to an independent tribunal, even if neither they nor their nearest relative has made such a request. We will also take a power to allow the Secretary of State for Health and Welsh Ministers to reduce that period.

Patricia Hewitt: I hope that I can reassure my hon. Friend on that point. We have agreed that it would be desirable to reduce the six-month period, which is why we will take order-making powers in the Bill so that as resources become available—we will, of course, need to expand the capability of the mental health review tribunals—we can reduce that period.
	We will amend the Mental Health Act 1983 to remedy a human rights incompatibility regardingthe nearest relative. We will also change the Mental Capacity Act 2005 to introduce the so-called Bournewood safeguards, following the Bournewood case in the European Court of Human Rights. Those new safeguards will be important for people who lack capacity and whose care unavoidably, and in their best interests, involves a deprivation of liberty, but for whom detention under the Mental Health Act 1983 would be quite inappropriate.
	I have already indicated that we tried, whenever possible, to reach agreement in another place, where the Bill has been extensively debated. In particular, we tabled an amendment in another place to ensure that the code of practice required under the Bill will contain principles and that the Bill will set out the issues that must be covered by those principles. I hope that the new clause, which I welcome, will reassure many of those who were concerned about the provisions of the original Bill and called for principles to be included in it. However, we believe that other amendments made in another place would damage patients and create the risk of harm to them, their families or the public. We cannot accept those amendments and we will try to reverse them in Committee.

Patricia Hewitt: My hon. Friend has extensive experience in the field and I hope that she will develop her point during the debate. Of course that is a matter thatwe need to consider, although it is primarily the responsibility of primary care trusts, working closely with local councils, to ensure that they have the correct resources available. In an emergency, they must be able to ensure that an assessment is made so that an authorised social worker—under the Bill, an authorised mental health professional—can decide whether to apply for detention in hospital for the purpose of assessment or treatment. I have no doubt that we shall return to that point.
	I stress that we have substantially increased the investment that the national health service makes in mental health services, as a result of which many thousands of mentally ill patients are getting far better care and treatment than was the case 10 or 20 years ago. However, there are still people with serious mental health problems who are not getting the treatment that they need, not only to protect them, but sometimes to protect the public from harm. We need to make changes to the legal framework to help to ensure that they get the necessary treatment, not only in hospital but, in line with modern medical practice, in the community. I believe that the Bill—or rather the Billas amended in Committee as I hope and intend itwill be—will strike the correct balance between modernising the legislation in line with the development of clinical practice, improving patient safeguards and protecting more people from harm. I commend the Bill to the House.

Andrew Lansley: It is interesting to hear the Secretary of State movethe Second Reading of a Bill whose principles now diverge substantially from those that the Government proposed, but such is the nature of today's debate. It probably will not be well understood outside that we will manage to have an argument while all agreeing that the Bill should be given a Second Reading, but we will carry on and do so anyway.
	The Government always say that the Bill is not about mental health services but, like the Secretary of State, I want to start by paying tribute to the people who work in mental health services. Hon. Members on both sides of the House will in a personal context, a family context and a constituency context have met people who work in mental health services, who do an often difficult job in difficult circumstances. People with psychological illnesses may present in similar ways to those with physical illnesses, but in some cases they can be very different—and very difficult to handle. The skills required of those who work in mental health services are remarkable, as are their forbearance and their patience in delivering those services. We should therefore start our debate by recognising what they do. The Conservatives think that, as a consequence, such people should be especially listened to. That has happened during consideration of the Bill in another place and, as it passes through this House, I hope—I know—that Members of this House will take a lot of trouble to ask people working on the front line in mental health services what they feel about the provisions. That may well change a few minds that might have started out a bit too set.
	I do not want to discuss at length the state of mental health services. You will recall, Mr. Deputy Speaker, that in February last year we had a debate in Opposition time in which we set out the issues in some detail. I hope that that will be taken as read. We acknowledge that additional resources have been provided for mental health services. Ministers often chide me, but I am prone to say that health services generally and mental health services have improved. From experience in my local area, I especially welcome the creation of crisis resolution teams and the introduction of early intervention and assertive outreach. Those are important innovations, as has been the development of the care programme approach. However, I hope that Ministers will be equally even handed and acknowledge that significant problems remain.
	Those problems include reductions in the number of in-patient beds and financial pressures on mental health trusts—even if they are not in deficit, they have to make savings as a consequence of deficits elsewhere. Despite the introduction of the care programme approach, only 50 per cent. of patients are subject to care planning. In addition, as the "Count Me In" census demonstrated, there are continuing problems relating to the discriminatory effects of the use of compulsion, especially in relation to black and minority ethnic patients. Those are all problems that we have to deal with, but as I am sure that Ministers would remind us, the legislation is not specifically designed to deliver services; it is designed to establish the legal framework under which people are brought under compulsion.
	We are discussing one of the less impressive talesof policy making of the last 10 years—and there is some competition on that score. It has long been acknowledged that the Mental Health Act 1983 needs to be brought up to date. A generation has passed since it was enacted, and as the Secretary of State rightly said, there are a number of issues that need to be dealt with, but let us consider the stages that we have been through. There has been a so-called blue paper, a Green Paper, and a White Paper—oh, and I left out Professor Genevra Richardson's expert committee report in 1998. I should not have done so, because it would have been a jolly good thing if the Government, who received that report right at the start of the process, had actually listened to what was said in it, rather than trying to cherry-pick from it.
	There was a 2002 draft Bill and a 2004 draft Bill, and a subsequent Joint Committee on the Draft Mental Health Bill report. Finally, in March last year, a few weeks after our debate on mental health services, Ministers acknowledged the inevitable—the fact that the legislation would not fly—and moved to an amending piece of legislation, which is what is before us now. I did not find, in any of the recent stages in which I have been involved, that the Government appeared genuinely to listen to the independent expert consensus that is emerging on how the legislation should be framed.
	It is true in a literal sense that the Bill is about the legal process for bringing people under compulsion, but there is a clear relationship between service provision and the case for compulsion. Those two things do not live in isolation from each other, and there is an important document, which was published in December, that needs to be read in that context. It is the five-year report of the national confidential inquiry into suicide and homicide by people with mental illness, which for convenience is called "Avoidable Deaths". In that report, clinicians were asked to identify the factors that they believed would have made homicide less likely. Let us remind ourselves whatthe results were, starting with the factor that theywere most likely to cite. They were: better patient compliance, which is not surprising; improved staff communication; closer contact with the patient's family; closer supervision of patients; and better liaison between different services. In more than 20 per cent. of cases, those were cited as factors that might have made the homicide less likely.

Andrew Lansley: Occasionally, I read the notes that I have prepared beforehand, and my next page says that the "Avoidable Deaths" inquiry identified what it regarded as the potential for prevention, and it mentioned 56 cases a year of suicide and—a figure that the Secretary of State did not mention—eight cases a year of homicide, because those cases related to the criteria for community treatment orders. Of course,the "Avoidable Deaths" inquiry was also clear about the lack of evidence, so we have to be understanding. In precisely the paragraphs to which the Secretary of State refers, it says:
	"We have no reliable way of calculating how many suicides would be prevented by a community treatment order",
	and it says precisely the same thing about homicides.
	That brings me back to my point about the Bill being about service provision as well as compulsion. If weare concerned to ensure that suicides, homicides and violence to others are minimised, what really matters, first and foremost, is the availability of services and the degree of appropriate supervision available to patients. The care programme approach and the availability of enhanced CPAs seems, on the face of it, and indeed on the basis of the "Avoidable Deaths" inquiry, to be the factor that is most likely to mitigate the risks.
	The Government ought to know that, becausethey went out looking for evidence to support their argument. They looked for evidence on community treatment orders, and that evidence was published just after the Bill's Third Reading in the House of Lords, so it was too late to be of any benefit to those proceedings, but I think that it would probably have reinforced their lordships in their conclusions. The review of evidence, by Churchill et al, which was published in 2007, said:
	"It is not possible to state whether community treatments orders...are beneficial or harmful to patients."
	It went on to say that there was
	"very little evidence of positive effects of CTOs in the areas where they might have been anticipated."
	The result is that the Government last week announced a further research project, which is to be undertaken by the university of Oxford and others. The Government have been proposing supervised community treatment orders for several years, and now they think it necessary to undertake research into their potential effectiveness. The Secretary of State was perfectly open about the Government's objective. She wants the Bill to complete its Second Reading, but then she wants to change most of it and overturn the amendmentsmade in the Lords. I suggest to Members wishing to participate in our debates that they read the debates in the Lords carefully. Those debates lasted for 45 hours, so I know that that takes a long time, but I urge them to do so, as they will find that powerful arguments were made and a great deal of expertise was brought to bear on the issue. I pay tribute to my colleague, Freddie Howe, to Lord Carlile, Lord Williamson, Baroness Murphy, Lord Rix, Lord Adebowale, Baroness Barker, Baroness Neuberger and all those who contributed their considerable weight of expertise and authority in the Lords.
	The Government tried to represent the argument as one between the rights of patients on the one hand and the protection of the public on the other, but that is a false dichotomy, as we can secure the rights of mental health patients and protect the public better than we have done until now. The Government, however, want to propagate that false dichotomy, because they want to force the argument in the direction that they want to take. Their attitude that they should have unrestricted access to powers is best seen in the assertion by the Minister of State, Department of Health, the right hon. Member for Doncaster, Central that
	"Every restriction is a patient untreated".
	That is both illogical and misleading. Compulsion is not the only route to treatment. Thousands of patients access services without compulsion. In the case of Michael Stone, the fundamental issue was not whether he was placed in a hospital under detention and regarded as not treatable but whether the services were available to provide the treatment that was regarded as necessary. Ministers go round talking about those cases—they do not do so openly; they do it privately—and if that does nothing else, it propagates the stigma experienced by mental health patients, which must stop.
	Thousands of patients access services without compulsion. Supervised discharge arrangements are available, and an enhanced care programme approach does not require compulsion. Discharge into the community should not happen earlier because CTOs are available. The principle should be straightforward: if patients need to be in hospital, they should be there; if they no longer need to be in hospital, they should be discharged. It does not require the legal establishment of a community treatment order for that to be the case. We are not against CTOs in principle, but they should be deployed as a means of securing compliance under strict conditions, and the Lords have put such measures in place where there is a history of relapse after treatment, where there is a history of refusal of treatment, or where there is a clear benefit from treatment if subsequently recalled.

Andrew Lansley: I am grateful to my hon. Friend, because the evidence taken by the Joint Committeehas been useful, and it will prove useful, too, in our considerations. There is deep concern not only among groups representing individuals with mental illnesses but among those individuals' wider friends, families and communities about the nature of the proposed legislation.

Andrew Lansley: First, we need to consider whetherit is more appropriate for someone who is at risk of harming themselves always to be under supervised discharge arrangements rather than under compulsion. As for the question of whether we believe that CTOs should be available only if someone is at risk of harming others, the answer is not necessarily. I know that an amendment to that effect was tabled in the Lords, and it is reflected in clause 32. We need to look at that very carefully, and consider whether in theory there are other circumstances. I wish to emphasise the fact that whether it is circumstances in which someone is at risk of harming others or whether they are at risk of harming themselves, we should assert the three R's—that is an easy way of remembering them—namely, relapse, refusal, and the result of treatment.
	It is astonishing that Ministers have resisted that. The Minister of State, Department of Health, the right hon. Member for Doncaster, Central has talked about revolving-door patients. That is the criterion that we are using, which is why we wish to include those measures in the Bill. It is therefore seriously misleading to imply that compulsory treatment offers access to services. I could hear that implication when the Secretary of State said that people were being denied access to CTOs and, by extension, to treatment. That is not true. They need not be denied treatment if services are available, and there is a range of mechanisms to make that happen. Compulsion should be the last resort—and this brings me back to the point made by the hon. Member for Slough (Fiona Mactaggart)—because it does not come without a cost. I do not mean financial cost, but the cost of compliance.

Lynne Jones: I was going to make the same pointas the Secretary of State, and I am pleased thatthe Opposition do not automatically support the amendment that was made in the House of Lords. While I agree that CTOs ought to be used sparingly, they are necessary. In fact, a majority of clinicians would like to have the option of CTOs and community supervision. I agree, however, that the availability of services is important. It is a scandal that a quarter of people who are compulsorily detained have been refused treatment in the past, and I wonder what the Opposition's view is on the need to introduce measures in the Bill that give people the right to assessment.

Andrew Lansley: I am grateful to the hon. Lady for those points, and I am reminded of an occasion on which I sat with consultant psychiatrists a couple of years ago or more. They said that at the end of the day there are circumstances in which they are under obligations not just clinically to their patients but to the community. There is a point at which to meet those obligationsthey would either have to put a patient who is inthe community into hospital, although they do not consider that they need to be there, or would have to seek additional powers, so they supported community treatment orders. We therefore do not object to the orders in principle, but we must be absolutely sure that we are creating safeguards in the legislation that make the measure a last resort, rather than a first resort.
	The hon. Member for Birmingham, Selly Oak (Lynne Jones) spoke about the right to assessment, but we must tread carefully. The Secretary of State made a point about age-appropriate services and assessment, and we must be sparing in the use of a legislative vehicle to mandate services. I do not think that we can go through mental health services trying to specify what they should do in the Bill but, as I shall explain in relation to age-appropriate services, it is sometimes necessary for legislation to express Parliament's firm intentions. I think that that is what the legislation currently does.

Andrew Lansley: Once again, the Secretary of State is making our argument for us. It is perfectly clear that far from resorting to CTOs, the Government should have been trying to work out how superviseddischarge arrangements can be used more effectively.  [ Interruption. ] Compulsion is not the same as supervision. What is required in order to promote patient compliance is, wherever possible, to achieve close supervision in circumstances that do not involve compulsion.  [ Interruption. ] The Secretary of State has said, "Well, they cannot be recalled." Of course it is possible for a section to apply, which could happen to any patient in the community. That may be for assessment in the first instance, but if the patient has been sectioned before, it may be for treatment. The Secretary of State seems to be making our argument for us, but I do not want to go on for too long, because I know that many hon. Members want to speak.
	Even more dangerous than the risk of non-compliance by patients would be if the use of CTOs were extended as an alternative to in-patient treatment, where that is desirable. Over the weekend, I published figures from the Department on the number of formal admissions under the Mental Health Act 1983. The Secretary of State has said that the Government want a shift out of hospitals and into the community. Well, the number of formal admissions has increased since 1997, while the number of in-patient beds has decreased by 20 per cent., including by 5 per cent. in the last year for which figures are available.
	With 63 per cent. of finance directors of mental health trusts saying that they are reducing their spending plans, the risk is clear. For financial reasons, rather than for reasons involving patients' interests, early discharge from hospital will involve community treatment orders. Early discharge should never occur because a CTO is cheaper; it should occur only in circumstances in which patients should not be in hospital. Cost saving by limiting in-patient detention is another potentially serious risk.
	I do not understand why the Government oppose the Lords amendments to clause 24 on age-appropriate assessment, services and accommodation. They have said that that would not be available in an emergency, but clause 24 is perfectly clear about assessment in an emergency, when it might not be possible to provide such facilities. It is clear that what is required in terms of accommodation is what is sufficient for the needs of children and young people and that what is sufficient for the needs of children and young people might be different in an emergency from what might be available when there is more time. As I said to the hon. Member for Birmingham, Selly Oak, Ministers must acceptthat Parliament wants to make it clear that it is unacceptable for three children and young people a day to be admitted to adult in-patient facilities. That must stop, and we must find not only the means but the will to make it happen.
	I have mentioned the safeguards on revolving-door patients, and I find it astonishing that Ministers will not accept the Lords amendment, which seems to deliver precisely the kind of safeguard that Ministers have called for.
	On therapeutic benefit, the Secretary of State and I had an exchange on the issue of personality disorder. That comes down to the question of medical necessity—is it necessary for somebody to be admitted under compulsion? In another place, the Liberal Democrat Lord Carlile, who cannot be accused of treating lightly the protection of the public, quoted Professor Eastman, who is professor of law andethics in psychiatry at the university of London and head of forensic and personal disorder psychiatry atSt. George's medical school. Professor Eastman has said:
	"Therapeutic benefit to the individual is of crucial importance in terms of protecting the boundary of what is the business of mental health professionals. I am not at all against protecting the public, of course not, but it must be in conjunction with some benefit to the individual that goes beyond simply stopping them offending. If you adopt a definition of treatability which is simply the reduction of risk or the avoidance of offending, that means that locking somebody up is treating them."
	We do not agree with the proposition that locking somebody up is treating them.
	This is a health Bill, and it must be about treating patients successfully. We have to protect patients from harm and we have to protect the public, and improving access to and the effectiveness of mental healthservices is the best way to achieve that. In specific circumstances, compulsory detention and compulsory treatment in the community will be necessary. Wehave a responsibility in Parliament to define those circumstances with the greatest possible care. I have no doubt that those circumstances must be determined by the therapeutic benefit to the patient as well as the necessity of compulsion to prevent harm to others. We must not widen the scope of compulsion to such an extent that it threatens patients and drives them away from access to services and compliance with treatment. Conservative Members welcome the Bill as introduced in this House, and unlike the Government, we will vote for it on Second Reading while agreeing with its principles.

David Blunkett: First, I congratulate my right hon. Friend the Secretary of State and her ministerial colleagues on persevering with this legislation in the face of misleading and, sometimes, scurrilous campaigning, which has led to great fears among those suffering from mental health problems. Those fears were expressed on the radio this morning, when someone who is willingly receiving support and treatment and gaining therapeutic benefit from it stated their belief that the Bill would take away their liberty. It behoves all those who are debating and campaigning on the Bill, with which I have been involved for a number of years, to be careful about what they say in order not to create unnecessaryworry. That includes the idea that 2,000 people will immediately be rounded up as though we live in a police state, which we do not.
	Secondly, I congratulate my right hon. Friend on the balance that she is attempting to achieve between the liberty of the individual and the protection and needs of the public. As she has rightly pointed out, she has a substantial personal background in this area, which she has brought to bear on the legislation.
	Thirdly, as part of the extensive listening that has taken place over the past few years by the Government, I hope that my right hon. Friend will ensure that issues of advocacy, which were originally in the legislation, which are being campaigned on by Young Minds and which are complicated—for example, a parent would not want a 10-year-old in the same ward as 17-year-olds with particular health problems—are resolved. I know that there is deep concern about that among hon. Members on both sides of the House.
	Fourthly, an issue that concerns the Zito Trust is that victims—or, more appropriately, victims' families—have the same rights in relation to murder and distress caused in the circumstances that we are debating as they would if action were taken under the criminal justice system, which was strengthened in that regard by the measures taken in 2003.
	We should be wary of presuming that because people have the right intentions they are automaticallyright. That is clearly demonstrated by the Lords amendments, which would create fear unnecessarily. Let me refer particularly to issues relating to exclusion. Some people assume that if the Bill does not specifically exclude the possibility that there is an evil regime just around the corner—even in my worst moments, I do not presume that that will happenafter the next general election, or the one after, or in50 years' time—that possibility means that issuesof sexual identity or orientation, or of people's involvement in disorder or in acts of cultural, religious or political belief, are somehow associated with its measures, leading them to believe that there is another agenda.
	When people believe that, they start making up in their own minds about what might happen. Take the shadow Health Secretary's views on therapeutic outcomes. Of course, we can debate an holistic approach and whether we can judge therapeutic outcomes in terms of managing someone's condition. However, in dealing with the question of community treatment orders, it ill behoves us to presume that those who are prepared to continue to receive support in the community, to accept their treatment and to continue to collaborate with the services are at risk of being dealt with under this legislation, because all Members know that they are not. We are not talking about people who would continue to take medication or receive therapeutic outcomes, but about people who would breach the decisions that were taken while they were in compulsory hospitalisation. All of us, perhaps with the exception of the Member who asked an inappropriate question earlier on, would accept that we have had compulsion for the past 125 years. We are debating precisely how we deal with the delicate area of people whom we know are at risk—or at least some psychiatrists would accept that they are at risk—because they have been into compulsory hospitalisation at least once. It is strange that those who rightly argue against revolving doors, and who would be deeply concerned about patients who were continually in and out of hospital without appropriate community action being taken to avoid their returning to hospital, have reversed the coin completely and are saying that they want to continue with a revolving door—presumably to the point where someone demonstrates by their actions that they are a risk to themselves and others. We cannot have it both ways.
	Nor do we want there to be a lawyers' field day, as there usually is. I have more than one regret about things that I did as Home Secretary, partly to do with the balance in sentencing and the misunderstanding with the judiciary. Another regret that I had as Home Secretary concerned the nature of people's understanding of what was taking place when we legislated. The more we legislate, the more lawyers make money—there is no question about that. In my view, they would have a field day if we left in place the House of Lords amendments. I should know, because they have had a field day in making money out of me—fortunately with success on my side. However, that does not stop me from being deeply suspicious of anything that means that people have to resort to law to be able to understand what we were trying to legislate about and its interpretation.
	For instance, I have experienced situations where people argued after a murder had taken place that the individual had a mental health problem and should therefore not be sentenced normally through the criminal justice system but be dealt with throughthe mental health tribunal. I have a terrible fear that the arguments are now moving the other way, whereby people would argue that the fact that someone was prepared to commit homicide demonstrated that they had a mental health problem, but were not prepared to accept, even though the person had been in hospital under detention before, that that could have arisen. These definitions and clinical decisions are very difficult. We must be careful that we do not impair people's liberty, but we must also be clear that if we fail to act, we let people down.
	I go back to the time when I was shadow Health Secretary, when I first met Jayne Zito. I pay tribute to what she has done over those years since the death of her husband, Jonathan. It seemed to me absolutely crucial that we listened and learned from such events, just as I listened and learned when I went to see the man with a mental health problem who tried to commit suicide, failed and ended up as a paraplegic. Of course, he was having to be supported and treated. He desperately wished that someone, as we would if we saw a person jumping off the parapet of a building, had been prepared to intervene—to grasp his hand and stop him doing it.
	We are trying, with difficulty and with all sorts of things being said about us outside the House, to get that balance right. I hope that with the support of this House we will eventually pass an Act that protects people from themselves and from others.

Norman Lamb: I accept that and certainly we will listen to the concerns as the Bill goes through Committee. I appreciate that there is a divergence of views on that issue.
	In 2004, the Joint Scrutiny Committee reached a conclusion that one would have thought would be largely uncontroversial. It said:
	"The primary purpose of mental health legislation must be to improve mental health services and safeguards for patients and to reduce the stigma of mental disorder."
	That does not appear to be the Government's view. The Government define the purpose of the Bill very narrowly. They say that it is
	"about the legal processes for bringing people under compulsion."
	Clearly, that is an incredibly important issue, but the divide in perceptions of purposes of legislation is remarkable.
	I want to say something about protection of the public. The Government make much of that, and in many respects rightly so. It is of course entirely legitimate and right to consider public safety and to ensure that people are not unnecessarily put at risk, but we need to ensure that legislation is guided by evidence, and it is incumbent on us all not to stir up fear where evidence might provide reassurance.
	The Government's approach appears to be based on an assumption that mental ill health, particularly in severe forms such as schizophrenia, is necessarily linked to violence and that the problem is getting worse, caused by care in the community and the inadequacies of the Mental Health Act 1983.
	What is the evidence? According to the evidence that I have seen, 5 per cent. of homicides are committed by people who have at some stage had contact with mental health services. That position has remained largely unchanged for the past 50 years. In other words, the emergence of care in the community appears to have had very little impact on those statistics—on those trends. Far more murders are committed by people under the influence of drink or drugs, and there is certainly no suggestion that we should be locking them up on a preventive basis.
	If we look at the number of murders committed by people who are currently suffering from a mental health problem, we again find little change. There have been 30 to 40 a year since 1997, yet the overall murder rate has increased by some 30 per cent. in that time, so murders committed by people with mental health problems form a reducing percentage of the total number of murders. Only one person in 20,000 with schizophrenia commits murder.
	As I understand it from talking to experts, there is also the problem that it is very difficult, if not impossible, to predict which person could be violent.I understand that attempts to predict are wrong in97 cases out of 100. We would have to lock up 2,000 to 2,500 people to prevent a single homicide. On the point made by the right hon. Member for Sheffield, Brightside, of course we are not suggesting that we are going to lock up that number of people, but if we do not, we do not achieve the objective of preventing people from being killed.

Norman Lamb: Of course, that will always be the risk.
	If we look at the findings of the various inquiries that have taken place into the tragic deaths that have occurred, we see that the focus tends to be on the human failures of those providing care and on inadequate resources, rather than on a lack of sufficient powers. The problem is always poor communication, poor care planning, overstretched professionals failing to heed warnings and inadequate service provision.
	I was listening to a consultant psychiatrist this morning, who was saying that it is the people who are not in the care of professionals, not the people already in the system, who are often the problem. The findings of the Michael Stone inquiry were typical of that. There was no recommendation for changing the law.
	Many observers have highlighted the concern that if the Government get their way, the public could end up less well protected. Two reasons are cited. First, the use of powers of compulsion is resource intensive. It tiesup professionals in bureaucracy and skews resources towards acute care and away from early intervention. The second reason is the risk that increased use of compulsion could drive service users away from mental health services.
	Dr. Tony Zigmond, the honorary vice-president of the Royal College of Psychiatrists, made that point today. He said that his experience is that the threat of compulsion can drive people away from the very services that can help them and make the public safer.

Angela Browning: I was present when Dr. Zigmond made that statement today, but it is not only him asan individual, eminent though he is, who takesthat view. It is the official view of the Royal Collegeof Psychiatrists as a whole profession. Those professionals do not want to have to take on the responsibility of picking out the people who just might some day commit an offence. That is an impossible task to ask professionals to do.

Norman Lamb: I have made the point that we accept the case that sometimes compulsion is necessary.The point is that it needs to be subject to stringent safeguards. It is the Government who talk the whole time about public safety. It seems to me to be distorting the debate to talk only about those cases. In my contributions, I was seeking to address the point made by the Government that the public will be less safe if the Government do not get their way. That palpably is not the case.

Norman Lamb: I absolutely agree with the hon. Gentleman.
	I want to state the clear principle that deprivinga person of their liberty when no crime has been committed is a very serious act, and we must always be aware of that. Those people have rights too.

Norman Lamb: I should like to make some progress, but I would be happy to give way later.
	The focus must be on ensuring high standards of service provision. The Government put this rather well in their response to the Joint Scrutiny Committee, in which they said:
	"In terms of the small minority of people with a mental disorder for whom compulsion might be necessary, we want to achieve a level and type of service provision that minimises the risk of people with a mental disorder deteriorating to the point where compulsion is necessary. When compulsion has become necessary, we want that service provision to be of a level and type to ensure that everything possible is done to prevent the need for any further episodes of compulsion. In other words, by improving the services to promote better mental health, we want to reduce the need for compulsion."
	I completely sign up to that statement of intent by the Government. It is a good basis on which to develop the law and our approach to mental health services.
	In the past 12 months, however, the deficits in the health service have had a damaging impact on those very mental health services in many parts of the country. I acknowledge the improvements that have been made in those services over the years, but in the past year, damage has been done. Before Christmas, the Health Committee produced a report on deficits which specifically highlighted mental health services as one of the "soft targets" that was suffering as a result of the cutbacks in funding. It is particularly depressing that those cutbacks should be happening just as the Government's emphasis appears to be on creating more draconian powers. This undermines the fine aspiration that they expressed in their response to the Joint Scrutiny Committee.
	I want to highlight the concerns expressed by many people about the potential impact of the original Bill on black and minority ethnic communities. The Minister will be aware of the genuine fear that, without proper safeguards, the Bill could disproportionately affect people from BME communities. Last December, it was revealed that a report by a Government advisory group chaired by Rabinder Singh QC warned that the Bill could lead to more black and ethnic minority patients being subject to compulsory treatment. Already, as a result of the Mental Health Act 1983, in-patients from black Caribbean, black African and other black groups are between 19 and 38 per cent. more likely to be detained compared with the average for all in-patients.
	In November last year, the Department of Health published a race equality impact assessment on the Bill. However, on 7 February this year, the Commission for Racial Equality announced a formal investigation into the Department of Health to
	"uncover the extent to which it is failing to meet its duty to promote race equality under the Race Relations Act 1976".
	Anthony Robinson, the CRE's director of legal services said:
	"We are concerned about the Department of Health as we have reason to believe that they have not been meeting their obligations under the law".
	What is going on? That is an extraordinary statement for the commission to make. I hope that the Minister will be able to offer some reassurance on thismatter. Improving the way in which people from BME communities are dealt with by mental health services clearly presents a significant challenge. The Commission for Racial Equality has called for amendments to guarantee the effectiveness of the race equality duty. Will the Government consider those proposals in a constructive way?

Norman Lamb: I am grateful to the hon. Lady for that intervention, but my point was that, under the existing regime, black and minority ethnic communities are treated disproportionately severely, and that if there is any increase in compulsion as a result of the Bill, there is every likelihood that those groups will be disproportionately affected by it. It is a question of logic. We must take the opportunity of this mental health legislation coming before Parliament to address the concerns about the way in which black and minority ethnic communities are treated, so as to ensure that mental health services do not discriminate against people from those communities.
	I want to deal with the amendments passed inthe other place which, in the view of the Liberal Democrats, must be preserved. First, there are the exclusions from the definition of mental disorder. The right hon. Member for Sheffield, Brightside talked about exaggerated language being used by those who oppose the Bill, but some of the exaggerated and misleading claims made by the Government have been enormously damaging to what should be a good, high-quality debate.
	At the Local Government Association conference last month, the Minister of State, Department of Health, the right hon. Member for Doncaster, Central (Ms Winterton) said that
	"by adding a range of unnecessary exclusions, the changes forced through by the Lords will inevitably open up new avenues for patients and their lawyers to use to try to secure the premature discharge for some of the most dangerous patients."
	That is scaremongering. The exclusions are about making sure that the powers are not used inappropriately. Similar exclusions exist in most comparable jurisdictions, including Scotland, and there is no evidence of dangerous people roaming the streets as a result of those exclusions being put in place in the Scottish legislation.
	I want to deal next with the amendments on impaired decision making. The Bill, as amended, prevents the compulsory treatment, including detention, of people who are fully able to make their own decisions about the provision of treatment. The Government claim that this will result in people who need treatment not being detained, putting them and others at risk. First, the Scottish legislation contains a similar provision and, again, there is no evidence of it causing a danger to individuals or to the public. Secondly, if someone with a physical health problem has the right to refuse treatment, should not the same rule apply to someone with a mental health problem? I think that the hon. Member for South Cambridgeshire (Mr. Lansley) made that point earlier. Thirdly, the Government's own expert Committee, the Richardson Committee, supported an impaired decision making test, as did the Joint Scrutiny Committee. Fourthly, mental health clinicians advise that a person with a mental disorder who is suicidal or who poses a risk to others because of their condition would inevitably be found to have impaired decision making, and so come within the scope of the legislation. So the amendment is a safeguard of real importance to the citizen's human rights, and does not leave individuals or the public at risk.
	Next, I want to deal with the treatability test. The Minister made an extraordinary claim on this in her speech to the Local Government Association. She said:
	"This safeguard has, on occasions, been misrepresented as meaning that patients can only be detained if they can be cured, rather than treated. This confusion has led to too many patients with personality disorders, which can be treated but not cured, being turned away from services."
	If that is the case, the answer is surely to ensure that professionals interpret the law correctly, not to change the law in a fundamental and dangerous way. The amendment addresses the Government's concern to ensure that someone with a personality disorder is covered by the Bill. It is a balanced amendment, and it should stay.
	The Richardson Committee said that a health statute should authorise overriding patient autonomy only if there are
	"positive clinical measures included within the proposed care and treatment which are likely to prevent deterioration or secure improvement in the patient's mental condition".
	Again, the Scottish legislation uses the same therapeutic benefit test, and there is no evidence of disaster in Scotland.
	The amendment on the renewal of detention is intended to provide a safeguard that is hard to dismiss other than on cost grounds. A medical practitioner would be required to examine the patient and to agree to their continued detention. Other health professionals have argued that the amendment goes too far, and we will take account of their arguments in Committee.
	I join in the criticism of the Government for publishing research on the international experience of community treatment orders the day after the Bill completed its passage in another place, which I thought was extraordinary. We know that the report had been available for a considerable time. Why did the Government wait until the deliberations in another place had finished? Surely it is better to allow informed debate than to deny us valuable information.
	The research revealed that there is little evidence of the positive value of CTOs. The Institute of Psychiatry concluded
	"there is no robust evidence about the effects of CTOs on key outcomes, such as hospital readmission, length of stay, medication compliance, or the patients' quality of life."
	The report advised that enhancing community services was a better way of improving compliance and reducing the incidence of relapse. Surely it makes sense to accept the argument for CTOs in a limited number of cases, along with the safeguards introduced by the House of Lords.
	The Minister claims that CTOs are intended to apply specifically to those dubbed "revolving door patients": people who leave hospital, relapse because of failure to take medication, and go back into hospital. The amendment was designed to ensure that CTOs would apply to precisely those patients. CTOs can impose wide-ranging restrictions on patients—many have described them as "psychiatric ASBOs"—and further amendments are needed to make them proportionate. It is important, for instance, to give patients the right to appeal to mental health review tribunals against conditions that have been imposed on them.
	Amendments that give health bodies a positive duty to admit children and young people to age-appropriate settings, and to provide specialist assessment and supervision for detained children, are fundamental to a civilised society. The Secretary of State said that it was not possible to ensure that something happened by passing legislation. I wish that the Governmenthad taken more note of that principle during the past 10 years, but in this instance we should surely set a standard. We must all accept that children should not be admitted to adult psychiatric intensive care units. It is nothing short of scandalous that one child or young person has been admitted to an adult mental health setting every day for the past three and a half years. It is also worth noting that the amendments are entirely in sympathy with the thrust of the approach recommended by the national service framework.
	The issues that we are debating are of fundamental importance. It is essential that we get the Bill right. It needs to stand the test of time, and it needs to have the confidence of those who work in mental health services. It is remarkable how cavalier the Government seem to be in the face of overwhelming opposition from those with real expertise.
	The Bill is not perfect. We want core principles to be set out in it, and I see no reason why that should not happen. I agree with the hon. Member for Stafford (Mr. Kidney) that those facing compulsion should have the right to an independent mental health advocate, and should be made aware of that right. But if the Government insist on driving through the removalof clauses added in the other place that provide safeguards for vulnerable individuals, they will make a very serious and dangerous mistake.

David Kidney: I agree with the hon. Member for North Norfolk (Norman Lamb) that it is not before time that we are updating our mental health law, as has already been done in countries such as New Zealand, Australia and Scotland.
	I support the Government in respect of nearly all the proposals that we have debated. They also deserve the congratulations that they received from even the hon. Member for South Cambridgeshire (Mr. Lansley) on their extra investment in the health service generally, and particularly in mental health. Before 1997 we experienced decades of underinvestment in our national health service, and no service was treated more harshly than mental health services, which is why practitioners described it as the Cinderella of services at the time.
	I can give an eye-witness account of the changes that have taken place. For nearly 20 years before I was elected to Parliament I was a solicitor in Stafford, where we have a very successful hospital for mental health treatment, St George's hospital. I regularly advised patients, had discussions and meetings with members of staff such as psychiatrists and hospital managers, and had dealings with the mental health review tribunal. I observed the problems that were created by underinvestment in services, particularly the lack of support for people in the community, which made hospital admissions more likely than they should have been. For the last 10 years I have been a regular visitor to that same hospital as the local Member of Parliament, meeting patients and other service users, doctors and nurses, and hospital managers. Today the story is completely different.
	During my time as the local MP, we have also seen the establishment of a private hospital dealing with mental health issues. The hospital, which is in Wheaton Aston in my constituency and is a member of the Huntercombe Group, specialises in acute illnesses and eating disorders in young adults and children. It is experienced in those conditions, and has made valuable comments about the parts of the Bill that deal with services for younger patients. Also in my constituency, Staffordshire university has a centre for national research on older people and mental health. As the local MP, I have seen a good deal that is relevant to today's debate.
	St George's hospital is part of South Staffordshire Healthcare NHS Foundation Trust. Let me say something about the way in which it has developed since 1997. It is now an exemplar for national services such as inclusion and regional services such as forensic sciences, and features local excellence in services such as developmental neurosciences and dealing with learning disabilities.
	When I visit the hospital, I see a brilliant commitment among its staff. There is evidence of that for visitors in the form of the magnificent modern learning centre—which is proof positive of the commitment of management to staff—and also in what the hospital calls the values exchange, which enables staff to swap experiences and suggestions of ways in which to improve services. That approach extends to service users, who show a fantastic commitment to the hospital where they have received treatment. Much of the credit belongs to the chief executive, Mike Cooke, who is so brilliant that he is leaving us next month to take up a post with a larger trust in Nottingham.
	I have also visited Huntercombe Stafford Hospital several times. It has great expertise in dealing with younger patients, and has much to offer this debate.
	We have seen two attempts at wholesale reform of mental health legislation in the past, both of which failed. I think it a shame that all our mental health law cannot be kept in one place as a kind of code: it is sad that we could not achieve such a modernisation. This Bill represents a more modest attempt to modernise the Mental Health Act 1983. Psychiatrists at both the hospitals I have mentioned tell me that there are advantages in that. The 1983 Act is familiar to practitioners. The definitions are well known to them, the practices are appreciated, and they like the idea of evolutionary rather than revolutionary change. There is also the opportunity to "mesh" the legislation with other reforms such as the Mental Capacity Act 2005.
	Like those practitioners, I ask "What is this law for?" I accept the Government's point that it is intended to provide a legal framework, but I still maintain that the quality of services is at the heart of the issue. With a good framework, services can flourish and meet need effectively; without it, they will be harmed. Like the Joint Scrutiny Committee I believe that
	"the primary purpose of mental health legislation must be to improve mental health services and safeguards for patients and to reduce the stigma of mental disorder."
	The top priority is to improve services through the Bill and many other means, including investment. The second is the reduction of stigma, which is vital in getting people to engage with services, with voluntary services being just as important as the compulsory ones that we are discussing. Compulsion must be balanced with the proper safeguards. Another important reform, mentioned briefly earlier, is work force reform.
	I should like to discuss the services available to young adults and children and I aim to speak later about the Lords amendment on age-appropriate treatment. I regret the fall-out between the Government and the Mental Health Alliance. The alliance is formed from a large number of organisations that all attract great respect for their work individually, so together they should be listened to. However, I do not share the alliance's enthusiasm for the Lords amendments on impaired decision making and the question of treatability. I like the alliance's arguments in respect of the overriding principles that it says should be in the Bill. Much of the disagreement between the Government and the alliance could be resolved if we put the principles in the Bill and got the wording right. We could certainly ease worries about the provisions on impaired decision making and treatability by getting those principles right.
	I am not sure whether we can get the principles so well stated in the Bill so as to do away with the need for some exclusions. The Government have concluded that the Bill must still mention exclusions for drug and alcohol dependency. I should like the Committee to discuss whether we can get a statement of principles that is so well honed that we do not need a list of exclusions as well. If we could get to that position, we would bring our legislation nearer to that of New Zealand, Australia and Scotland, which we are now falling behind.
	Some safeguards are missing from the Bill, and if I am a member of the Committee I will argue for them. The first is the one I mentioned to my right hon. Friend the Secretary of State: the right to independent advocacy for those subject to compulsory powers. The second is the legal recognition of a patient's advance decisions and statements. The third is enabling patients to have greater choice and covers which persons exercise the powers granted to the nearest relative.
	On the vexed question of community treatment orders, it is important to bear it in mind that we have experience of some controls over some patients inthe community. We have the extended leave and guardianship route and supervised discharge, or aftercare supervision. In itself, the idea of having conditions that enable people to be in the community rather than in hospital is accepted, and has been for many years in this country. However, community treatment orders would be a new provision. They are used around the world, but the research on the beneficial effects of those provisions—let us face it, they are fairly new in most of the countries concerned—is not yet conclusive one way or the other. It makes sense for us to have a cautious approach to the use of those powers and their application. But the Lords amendment goes much too far; the conditions that it puts on the application of the provision might kill it.
	On work force reforms, it is desirable to build up the multidisciplinary team that will be responsible for providing services both in hospitals and, crucially, in the community, and to build up people's confidencein it.

Angela Browning: The Minister is nodding her head the wrong way, from left to right. I want it to go more north to south. I shall make this case again if I serve on the Committee. The Minister has heard me make the point before.
	The difference of knowledge of this subject now compared with 1983 is clear. I have been very critical of psychiatrists and I am pleased to say that they are responding in the way in which they treat people with autistic spectrum disorders, particularly Asperger's syndrome. But if we have a combination of diagnoses—an ASD diagnosis and a mental health diagnosis that are quite distinct and separate, or even a triple diagnosis of an ASD, a learning difficulty and a mental illness—we require people with a lot of experience and specialisms to sort out the behavioural messages coming from those different diagnoses.
	My worry about the broadening of the definition of mental disorder is that for many people with an ASD, what many of us would regard as "normal" autistic behaviour will be misdiagnosed as psychotic behaviour because there are simply not enough mental health professionals around the country to be able to disaggregate those different behaviours. As I haveoften said, the result of that is misdiagnosis and mistreatment, which can have a serious and adverse effect on the health of an autistic person and on the environment into which the person is taken. One would put someone diagnosed with ASD into a hospital only if one were 100 per cent. sure that that was truly the last resort, because that environment itself would be extremely disturbing to them.
	Advocacy is related to the issue I have been addressing, but it has broader implications in terms of mental disorders generally. I am pleased that under the Bill the Minister has closed the so-called Bournewood gap, about which she and I have had many discussions, by amending the Mental Capacity Act 2005. However, huge advocacy implications arise from closing the Bournewood gap, and other advocacy implications arise from the rest of the Bill. Therefore, it is with some distress that I learn that the Minister has reduced the amount of support—legislative and otherwise—that would give appropriate levels of advocacy to mental disorders both generally within the context of the Bill and particularly in terms of closing the Bournewood gap. In Committee I hope that she will propose impact assessments in respect of advocacy for the Bill as a whole and particularly the advocacy requirements that she anticipates will be needed to do true justice tothe way in which she has decided to close the Bournewood gap. I am unsure whether information on that is available now, or if it is being worked on.  [Interruption.] The Minister is replying from a sedentary position, but perhaps she could respond to that later.
	I have participated in many mental health debates in the House, and I wish to share my experiences not only on the autism front but of other cases that I have dealt with, particularly as a constituency Member of Parliament. I have had many cases where people have committed suicide, sometimes while they were in-patients, unfortunately. Some committed suicide after they had been an in-patient and had received community services. I dealt with one tragic case of somebody who was treated in the community and who ultimately murdered his mother. In all those cases, when I read the medical records—they have been made available to me—it is clear that there are common themes. There is a lack of early intervention: there is a long journey from the moment when the symptoms or concerns first begin to getting the person concerned in front of the professional who might be able to help. Having got to that point, there is also an issue to do with the long, ongoing treatment. Members understand that many people have cyclical conditions where there is a period when they are fairly stable but then go down, as that is the nature of many mental health disorders. However, there is often a lack of continuity in intervention so that such people simply fall through the net. That is a common theme in all the cases I have dealt with, including those ending in suicide and the one case where somebody else was found dead.

Andrew Dismore: I speak in this debate as the Chairman of the Joint Committee on Human Rights and in support of our report on the Bill. The Bill is of major importance for the human rights of those with mental disorders, which is a highly vulnerable group, including the right not to be subjected to inhuman or degrading treatment, the right of persons of unsound mind not to be deprived of liberty save in accordance with a procedure prescribed by law, and the right to respect for private and family life.
	I know that the Government accept that this legislation must comply with our human rights obligations. The Secretary of State has certified her view that the Bill is compatible. My right hon. Friend the Minister helpfully wrote to me on the introduction of the Bill. She also wrote that the Government had conducted "an ECHR audit" of the Mental Health Act 1983, the principal piece of legislation amended by the current Bill, and that in respect of the 1983 Act they were
	"not seeking to leave in place any provisions which we know or suspect to be incompatible".
	While I commend the Government's approach to human rights in drafting the Bill, there remain issues on which my Committee has a different view.
	We reported on the Bill in another place and amendments were made there, responding to some of our points. I am grateful for the Minister's recent comprehensive response to our report, which we will publish soon. My Committee might report further, so it would be helpful to have a clear indication today of whether any of the amendments made in the other place will be accepted.
	Mental health law is highly complex, so it is important to set out the arguments behind the JCHR's concerns, to ensure that the House is aware of those human rights considerations. We considered that, broadly, the Bill satisfies the criterion of
	"objective medical evidence of a true mental disorder"
	for psychiatric detention to be lawful. However, we had concerns over the broader definition of "mental disorder" in clause 1. Given its breadth, we believed that it was desirable to include the principles of non-discrimination and proportionality in the Bill. On Third Reading in the other place, clause 10 was added, requiring fundamental principles to be taken into account when revising the 1983 Act's code. Those include "minimising restrictions on liberty" and "avoidance of unlawful discrimination". That was a welcome development, although it would be preferable to see those principles made directly applicable under the Act, rather than indirectly through the code.
	As it currently stands, clause 3, which was not supported by the Government, narrows the definition of mental disorder, so that people could not be considered to have a disorder for the purposes of the Act solely on a number of grounds: substance misuse; sexual identity or orientation, which we considered in our report; commission, or likely commission, of illegal or disorderly acts; and cultural, religious or political beliefs. That clause provides an extremely important safeguard.
	The Bill replaces the original test for detention of a person for treatment, which was that that treatment was
	"likely to alleviate or prevent a deterioration of his condition"
	with the new rule, that
	"appropriate medical treatment is available for him."
	In strict convention terms, the JCHR saw no obstacle to that, although we noted the ethical concerns expressed by psychiatrists that they should not be custodians for preventive detention, but should be providing treatment of therapeutic benefit. Clause 5(3) reinstated a likelihood of benefit of treatment, and it would be a pity if the Government were to seek to overturn that.
	The JCHR had stronger concerns as to whetherthe "appropriateness" test was sufficient to ensure convention compliance for treatments without consent requiring a second opinion under section 58 of the 1983 Act, such as pharmaceuticals for mental disorder or electroconvulsive therapy. We also considered that forcible feeding and other treatments invasive of physical integrity such as ECT should be subject to the same second opinion safeguards. In her recent letter, my right hon. Friend the Minister said that she would consider that, which I welcome, and we urge her to implement our recommendations.
	On renewal of detention, rather than just the initial decision to detain, we shared the concerns of JUSTICE and the Council on Tribunals that the Bill provides for renewal on the report of a "responsible clinician" who need not be a doctor. That could mean that the decision is not in accordance with the need for objective medical expertise.
	Clause 6 prevents a responsible clinician from renewing detention without the agreement of a registered medical practitioner who has examined the patient. We regard that as an important protection, which conforms with Strasbourg case law, and we would be very concerned if the Government opposed this clause.
	In the ECHR case of JT, a patient claimed that she had no right to change her nearest relative, who was required to be informed when, for example, she made an application to a mental health review tribunal for a discharge from detention. Her nearest relative was her mother, who was living with a man whom the patient alleged had abused her. The ECHR concluded that the patient's article 8 rights to privacy and family life were being breached, so the Government undertook to introduce legislation, first to enable a patient to apply for replacement of a nearest relative on reasonable grounds and, secondly, to prevent certain persons from acting as the nearest relative.
	The Joint Committee agrees that clauses 26 to 29 of the Bill appear to meet the terms of the settlement in JT. However, given that applications to displace the nearest relative may be made by others, including hospital authorities, we had concerns that the new ground for replacement, of "unsuitability", might be used to displace people who were merely seen as "difficult" by those authorities. We also believe that "unsuitability" is too broad a test to meet the Government's apparent intention that patients would be able to displace nearest relatives only in situations of abuse or suspected abuse.
	We commented in our report on the procedure for community treatment orders, which place conditions on patients living in the community, and especially the breadth of conditions that may be imposed. In the JCHR's view, any restrictions on conduct should be proportionate, and a patient should be entitled to a review of those conditions by a mental health review tribunal.
	Mention has been made of Bournewood patients and some of the most complex provisions are in part 2, which amends the Mental Capacity Act 2005 to meet the Strasbourg judgment in the case of HL. HL was a compliant, incapacitated patient. The ECHR found that his admission to, and detention in, hospital, under the common law of necessity, breached convention articles 5(1) and 5(4). We reported that the procedures for legal authorisation to detain a compliant, incapacitated patient are unduly cumbersome and we doubted whether, even with professional advice, residential care home managers would understand them.
	We are also concerned that the effect of Government proposals will be to apply means testing, charging persons deprived of their liberty and living in residential care homes for their care. That raises important human rights issues under articles 5 and 6; as well as discrimination issues under article 14, in that people deprived of their liberty in hospitals will not be similarly charged.
	In our report we suggested two enhancements to the Bill. The first relates to the treatment of Bournewood patients, because the inadequacy of safeguards for them is very serious, given that they lack the capacity to consent. We do not believe that the common law and the Mental Capacity Act currently provide sufficient protection for the physical integrity of such patients. In particular, more needs to be done to address the issues raised in the case of Storck  v. Germany, which concerned state control over private psychiatric institutions. The Bill would be an appropriate vehicle to introduce such provisions.
	Secondly, we were concerned about the use of seclusion: safeguards should be placed in the Bill to ensure that seclusion is only used when strictly necessary and is subject to review.
	There are other issues on which we did not comment directly, and the points that have been made about advocacy are very important. We also did not refer to the effect of the Bill on the rights of child mental health patients. I note and support the clause 24 amendment in the other place to require primarycare trusts to provide age-appropriate services and accommodation for children and young people. I hope that we will be able to report further on the Bill to take account of some of the additional points that have arisen in the debate.
	The Bill, of course, is about much more than human rights, as we have heard in the debate so far. Indeed, I think that this is the first contribution to refer to the issue of patients' human rights in this context. I hope that the House will take into account the human rights of those vulnerable mental health patients who are detained or compulsorily treated by the mental health system in further consideration of the Bill today and in Committee.

John Bercow: It is a great pleasure to follow the hon. Member for Hendon (Mr. Dismore), many of whose concerns I share. Notwithstanding those concerns, my view is that the Bill should receive a Second Reading tonight precisely because of the welcome and protective amendments that were made on a cross-party basis and with great expertise in the House of Lords.
	I listened carefully and attentively to the Secretary of State as she introduced the Bill this afternoon. She invoked, in support of the Government's determination to reform the treatability provision, the need to catch within the net people who currently are not being caught. Specific reference was made, and justification was provided, in the cases of people with severe personality disorders. I have to say that I have listened over a period of weeks and studied some of the evidence, and my distinct understanding was that there was a misapprehension about that category of person. In so far as such people have not been treated in the past, it is principally because of a combination of reasons, including an absence of resources; a mistaken and outdated belief that such people could not be treated; and, as the corollary of those two states of affairs, the lack of effective treatments to secure the desired result. If in fact one secures a proper interpretation of the existing legislation and one has the resources to deliver what is necessary, it seems that that fox is easily shot.
	I respect the Minister's intentions and her humanitarian philosophy, but I suggest that she is wrong on this issue. The use of the term "appropriate treatment" is far too broad and potentially invasive. I do not think that it can be justified. Ministers were put to the test in the other place by Lord Howe, Baroness Barker, Baroness Meacher, Baroness Murphy andLord Carlile—to name but a few—who tabled an amendment that said "we don't want that. What we want is to ensure that there is provision that will guarantee that the alleviation of, or the prevention of deterioration in, the condition should be the criterion that has to be satisfied if compulsion is to be deployed." That is entirely reasonable. If the Government think that people will benefit—that a therapeutic gain will be derived, or an improvement or prevention of deterioration in the condition will, in most circumstances be the predictable consequence—I do not know of what exactly it is they are afraid.
	I do not doubt the intentions of the Minister and I do not seek to impugn her integrity, but if the Government get their way, the inevitable prospect is held out of an expansion of preventive detention, if not on an industrial scale, at any rate in terms of significant increases in numbers. Simply as a matter of logic that must be what is portended by Government intentions. If the Government do not intend in any way to change the numbers, why do they need to go to such lengths to defy the professional wisdom and changethe law?
	My view is that the Government are wrong. They should accept the Lords amendment and there is a powerful consensus on that point. It is the view of the Joint Committee and of the Richardson review, which was requested by the Government. It is the considered judgment of the House of Lords and the opinionof the Mental Health Alliance, as well as the determination of the Scottish Executive. In terms of humility, the Minister might like to consider the possibility that she is in splendid isolation for the simple reason that she is mistaken.

John Bercow: I did not say that we should turn our backs on them, but that we should have respect for them and be willing to accept the verdict they give. That is where, in a sense, never the twain shall meet between us.
	Finally, in terms of the Bill's architecture, I turn to the subject of community treatment orders. Let me say at the outset that there is scope for some consensus on this point, although I do not particularly approve of the way in which the Government handled the matter—the evidence was suppressed and published late, which seems rather a pity—but the suggestion has been made that CTOs could be the way forward for the structure of modern provision in the community. I see some merit in that suggestion although I think that the case is unproven.
	My argument is not against the community treatment orders per se, but rather, as articulated by the hon. Member for North Norfolk (Norman Lamb), against what seems to be envisaged in terms of conditions and restrictions on the lifestyle of the people who would be subject to the orders. Whatis proposed by the Government in a rather all-encompassing power seems to me quite frightening. It is a disproportionate, far-reaching and adverse provision that could have an impact on a great many people. There is reference to the entitlement to impose a condition that a patient shall refrain from "particular conduct"—conduct gloriously unspecified. Might Ministers have it in mind to say that patients should not be allowed to go to a public house, or that they should have to observe a curfew from six in the evening until six in the morning? I do not know quite what Ministers have in mind, but we have to be careful that we are not guilty of an intolerable infringement of human rights and, throughout the Bill, an approach that would have another damaging effect in practical terms—to drive mental illness underground. We do not want to do that. United across the House would be the conviction that we must avoid that eventuality; the disagreement is about the means to do so. I listened to expert voices, including that of the former chief executive of Broadmoor, who is known to me and who says that is his particular fear. Many others have said the same.
	Having expressed my concerns about the Government's intentions on treatability, severe impairment and the conditions to be imposed in CTOs, I conclude on this point. In the media—especially the less responsible and more hysterical elements thereof—there is all too often a single view of the mentally illas a homogeneous and undifferentiated group who should, almost without exception, be regarded with suspicion, anxiety and probably foreboding, too. That is to do a great disservice to hundreds of thousands, indeed millions, of people who at some time in their lives suffer from mental illness. My appeal to the House is to accept that, whatever our views, Parliament has a duty in this matter not to play to the lowest common denominator—I do not suggest that the right hon. Lady is doing so and I hope others will not suggest that either. We should not in any sense fan the flames of popular and misguided prejudice; rather we should seek to raise our game, to recognise that pertinent and compelling points have been made to us by the mentally ill, by people with extensive professional experience and by Members of the other place who spent a great deal of time in detailed scrutiny and deliberation of these matters. I am sure that some of what the Government intend, and which is in the Bill, will be of benefit, but I worry about Ministers' fixity of purpose at this stage, when they say, "We don't like those amendments, they're bad news and we shalluse our majority to get rid of them". I appeal tothe Government, in the interests of the mentally ill, the community as a whole and the reputation of the House, to think again. It is not too late.

Chris Bryant: It is always a delight to follow the hon. Member for Buckingham (John Bercow). It is a delight, too, when he joins us in the Division Lobby, which he seems to be doing more regularly of late—I do not know whether it portends anything.
	I particularly wanted to speak in the debate because I have had a few experiences of mental illness, although not in my own life. My mother committed suicide after many years of alcoholism and several attempts at suicide. She had been in many psychiatric wards and followed many forms of psychiatric treatment and she died in 1993 from a cocktail of paracetamol and alcohol—she probably took her own life.
	One of my first and most difficult cases as a Member of Parliament involved a delightful and sensitive young man called Matthew Davies. He, too, had an alcohol problem and committed suicide on Saturday 29 June 2002. In his case, too, there was a pattern of self-harm. At the time of his death, he was on a community rehabilitation order so he was in regular contact with the criminal justice system through the probation service, with many forms of medical treatment, with the local authority and with housing associations that were trying to find suitable housing for him, his girlfriend and their baby. Throughout the processit became clear that a combination of different organisations failed him, although I do not say that to attribute blame to anybody. He took his life having rung for help only the day before. He found it impossible to get additional help from the professional services.
	Another case involved a friend of mine—the actress Lynda Bellingham, whom many Members may know as the Oxo mum. She owned a flat two floors above her home and let it to a tenant in 2001. After a month or so, it became apparent that he was not well when he started to accuse her and her sons of shouting obscenities at him and stalking him. She had to have him removed from the flat and a few months later the police came round to tell her that he had accused her son of firing pellets at him, despite the fact that her son was abroad at the time.
	Then there was a solicitor's letter, saying that she had been stalking this man, Mr. George Millar. By the following February, things had gone quiet until oneday a home-made bomb was thrown through her window—a brick wrapped in a lit firework and a tee-shirt that had been doused in petrol. Her tyres were slashed and the police mounted an investigation. In fact, they had already mounted several previous investigations. When they arrived at the man's house, the screensaver on his computer said, "Revenge, like Oxo, is a dish that is best served cold".
	That story is particularly chilling because although the police and the authorities took action, it took a year for the case to go to court, during which time the man was under detention. He was charged with arson and threat to kill, but the judge said that he was not in a sufficient condition to be judged by a jury and that if the woman was prepared to drop the charges, he would ensure that the man was sectioned. Unfortunately, two days after she had withdrawn the charges, the police came round to her house to say that since the man had been in psychiatric care for the last year, he was well enough to be out on the streets. In fact, his then girlfriend acknowledged a week later that he was not taking his medication as he had promised. He was readmitted to a psychiatric hospital from where he escaped, after hitting one of the psychiatric nurses over the head with a chair. Eventually, he hanged himself in his room.
	In that case, it is abundantly clear that the combination of the criminal justice system, forensic psychiatry and the psychiatric health system had failed the man, failed the woman and failed the community. It is thus important to move forward towards a better combination of all those different services so that we serve the individuals better. I believe that this is primarily about the safety and care of the individuals themselves rather than that of the wider community. Several hon. Members have made the point that the number of those who self-harm and commit suicide is far higher than the number of homicides relating to people who have been in psychiatric care, which is why I believe that individuals should be the prime focus of our debate.
	My basic principles are pretty simple. The first isthat there is still an enormous gap in provision. The Government have done a lot to increase provision, but the talking therapies that are available in wealthier middle-class areas are not available in poorer areas. That is partly because many poorer communities do not produce the number of local counsellors or people trained in these therapies that the other areas do—an issue that we need to address.
	Another concern is that in far too many areas of the country, the response to depression and many of the lesser psychiatric illnesses from which many people suffer and which can be cured, is merely pill popping. Many of my constituents are on incapacity benefit because they have got used to years and years and years of taking antidepressants and have become addicted to them.

John Bercow: In pursuance of the point made by the hon. Member for Walsall, North (Mr. Winnick), may I press the hon. Gentleman on a specific question ofthe conditions imposed on people on community treatment orders? Given that there is a potentially draconian power here, does the hon. Gentleman agree that people should at least be allowed to appeal against an imposed condition?

Chris Bryant: That is an important area that needs to be discussed and should be teased out in Committee.
	I believe that we do not yet know everything that there is to know about a whole series of mental disorders. The hon. Member for Tiverton and Honiton (Angela Browning) made an important point about progress with autistic spectrum disorder and I am sure that the same will apply to many of the personality disorders that, 20 years ago, were considered absolutely untreatable, incurable and beyond the pale. I believe that in 20 years' time we may have a completely different attitude, which is why it is so important to have legislation that is able to meet changing perceptions in the future.
	There are two specific areas in which I am not entirely sure that the Government have got it right. The first is the issue of appropriate treatment—the so-called treatability clause. I believe that the amendment passed in the House of Lords places a very high hurdle, but it is not actually the hurdle that the hon. Member for Buckingham gave us, which was actually a variation of the Lords amendment. In fact, his was a much lower hurdle because he put several qualifications into it.
	Innovative treatments will come along in the next10, 20, 30 or 40 years in respect of which no clinician will be able to guarantee that they will ameliorate the condition or, indeed, prevent deterioration of it—certainly not in the first few months. The very fact of detention may lead to deterioration of the condition for a short period, but the mere fact that one cannot guarantee that that effect will be produced, as the House of Lords determined it, should not necessarily lead to an automatic get-out clause. I think that it is possible—

Chris Bryant: I doubt whether many lawyers would agree with the hon. Gentleman about the meaningof "likely". That is precisely the problem, as many clinicians have expressed to me.
	Another important issue is the exclusions in the 1983 Act, which are not in the Bill. I question—it is no more than that—why it is seen as right and proper to detain someone under the Bill for bulimia or anorexia nervosa, while exempting people in respect of alcohol or substance abuse. In practice, many of the treatments might well prove to be similar. Many of the processes that would have to be gone through would be the same and there is an element of compulsion. Yet many people treating anorexia nervosa and bulimia would say that volition is a very important part of the process of treatability.
	I also question the removal of the exemption for sexual identity, sexual deviancy and promiscuity. I understand what the Government are saying, but no one today believes that being homosexual is a reason for putting someone in a psychiatric ward. I entirely accept that. However, if sexual identity or orientation is not such a big issue, why not allow the Lords amendment to retain the provision?
	I also question how the treatment of paedophilia is handled. The law may well want to allow a clinician to detain someone whom he believed was about to engage in paedophile activity. However, according to the clinical definition, only 5 per cent. of child sexual abuse cases are actually perpetrated by clinically defined paedophiles. Any clinician I know who felt that a patient had a tendency towards paedophilia would be most likely to refer him to social services or to the criminal justice system. That is the proper place for that to be dealt with. Of course, it is also possible to draw an important distinction between somebody who believes themselves to be God and somebody who believes in God, so it should be possible for us to have an exemption for religious belief. But it is important for the Government to remember that the House of Lords wording retains the word "solely", which is an important hinge in terms of how the provision works.
	Finally, I pay an enormous tribute to those who work in mental health. The people who work voluntarily at Hafal in my constituency and those who deal with many people with very chaotic lifestyles do a job that many of us would find impossible.
	Several hon. Members  rose —

Richard Taylor: I very much welcome the contributions that have been made, particularly by Labour Members, because they show that there is some support for some of the House of Lords additions to the Bill, most of which I support very strongly.
	On a light note, I am delighted that the exclusions under the definition of mental disorder include political beliefs. When I stood for election to this place, I was not actually accused of being mad, but I was certainly accused of being a militant activist, a medical dinosaur, Swampy and even King Canute. I am absolutely delighted, therefore, that there is no chance that abnormal political beliefs could be included.
	I want to say a little about treatability, because so many Members have concentrated on it. What do we, as doctors, mean by treatment? First, the ideal is a cure. Obviously, infections can be cured, and depression can be cured in many cases. Secondly, if we cannot cure, we want to control. Diabetes and hypertension can be controlled. Schizophrenia can be controlled with the right treatment and the right follow-up, and nobody would argue against detaining people with treatable schizophrenia. The third bit of treatment is palliation. If it is incurable, cancer can be palliated. The neuroses can also be palliated, as can some of the psychoses if they cannot be helped otherwise. With the addition of psychological treatment, some people with personality disorders can perhaps be helped, but it is a very big "perhaps".
	I personally like the phrase
	"likely to alleviate or prevent a deterioration"
	in the House of Lords amendment; it takes me back to my time working as a physician taking in emergencies. We took in well-known psychopaths from the accident and emergency department, but it was impossible to get one's psychiatric colleagues to help at all once a psychopathic personality had been diagnosed. I always remember one chap who came in having swallowed a parcel of nails. He was assessed by psychologists and did not have a psychological illness, so we had to let him go. The only way we could have settled our consciences when we let him go would have been by taking his supply of nails from him, but he would not let us take them, because that was robbery. I ended up having to buy them from him, and he no doubt moved on and tried the same trick somewhere else. The point of mentioning him is that no amount of psychological advice or anything else would have dealt with him. Unless we include the House of Lords amendment, such people might be at risk of being locked up for ever and a day, because there is no way anybody would change them.
	On clause 4, which deals with impaired decision making, because of the restrictions of time, I will only point out the Law Society's absolutely excellent paragraph on that subject. It is very short, but it isan excellent, explicit explanation of the Lords amendment, and it should be read by everyone.
	Moving on to the renewal of detention, the fact that the Lords want a doctor to be involved has already been mentioned. I was pleased to learn this morning that the Medical Health Alliance has slightly changed its stance and agrees that there is a very strong place for professionals other than doctors to be involved, but at least one of those involved must be medically qualified. I have a fear that, in the national health service as a whole, the moving of certain tasks to professionals other than doctors possibly happens because it is a cheaper option and, perhaps in some cases, as a response to the deficits.
	On clause 32, which deals with a doctor being involved in the decision to place the treatment on a community treatment order, I have learned of the tremendous usefulness of assertive outreach teams at home. They are excellent when they are adequately supported, and I am very keen for the Government to consider the support that assertive outreach teams get. As other hon. Members have said, mental health services are always soft targets when one is trying to balance the books, and it should be a target for the Government to help those teams. It has always puzzled me why there is no target for the time taken to see a consultant psychologist. That seems to be a complete gap.
	Turning very briefly to young people, a lot has been said. When I was still working, which was a few years ago, to walk into an adult psychiatric ward would put almost anyone off, and to put children into those circumstances would be awful.
	I wish to conclude with two very important things. First, as has been mentioned several times, the Mental Health Alliance—the broadest coalition in the mental health world, with 79 members, and a unique alliance of all the groups—supports the Lords amendments with slight provisos, one of which is about doctors' opinions, but it cannot be swept aside. The Mental Health Alliance says that reform
	"must be fair and workable".
	The Royal College of Psychiatrists says that reforms must
	"command the support of the professional groups and patients".
	To conclude, I can say as an independent what party members possibly cannot say, and this is an appeal to the Government that this is not a political issue; it is an issue that we must get right for the good of all the patients who suffer from such illnesses. I shall leave the House with some words from a far more eminent independent MP than myself: A. P. Herbert, who was the independent MP for Oxford University before world war two. He wrote in his book:
	"I have even thought that, on great occasions where the parties were furiously raging together, the votes of Independents, cast with, of course, more conscience, might be as straws in the wind and show the party leaders which way the pure air of free opinion blows."
	I think that the pure air of free opinion blows in favour of a lot of the House of Lords amendments, and I should very much like the Government to support some of them.

Meg Hillier: Time is short so I will not go into some of the details of mental health issues in Hackney. I managed to mention some of them in an intervention. People in Hackney are three times more likely to be admitted to hospital with schizophrenia than people across England as a whole. I highlighted in my intervention particular issues about people from black and minority ethnic communities. Although that was the reason why I began to look in detail at the Bill, this is not the Bill that tackles those many concerns. However, the Bill does deal with the important area of compulsory treatment and how and when it is applied.
	I have had the opportunity to canvass opinion from a wide range of sources and I pay tribute to the people I spoke to for their time and expertise. In particular, I pay tribute to Hackney Mind and the service user group there, and members of the staff of the East London and The City University Mental Health NHS Trust, including nurses, approved social workers, consultants and other mental health professionals. I also pay tribute to some people who have not been mentioned so far in the debate: tenants, residents and housing managers, who have to deal a lot with the reality of mental health issues on a daily basis.
	Because time is short, I am going to focus on only two issues in the Bill. I hope that, if I am lucky enough to serve on the Committee, I will get the chance to probe these and other issues in more detail. The first issue is the compulsory community treatment order, which is one part of the Bill that I welcome. Treatment on the basis of need is a principle that pervades the national health service. Even when consent is not possible, because somebody has not got the capacity to identify their need, that treatment should still be forthcoming. That basic principle protects patients with mental health problems. The patients and service users that I spoke to had mixed views about the matter, as one might expect. The main concern of mental health users that I spoke to was to ensure that the care package, whether it be voluntary or compulsory, was properly delivered. There is further debate to be had—but again the area is not properly part of the Bill—about the way in which care packages are delivered. I hope to go on to that in more detail in the second half of my comments.
	I will give some comments from users themselves, because their voices have not been heard enough in the debate. One of them said to me: "At least in hospital there is monitoring, but in the community you can feel lost." Possibly with compulsory community treatment orders that feeling of being lost may be addressed. Someone else said: "It would be better if people were not going to hospital so often." That individual's view was that, if compulsory treatment in the community was forced upon them, that would be better than being forced to go into hospital. That comment came from somebody who had a mental health problem and who, when she was not in her worst condition, was aware of the problems and had the capacity to judge her situation. Others had concerns about being forced to take medication—because of the bad side effects. That is obviously a huge issue for people who have to suffer the many uncomfortable side effects of medication. One person said that, in her case, medication may quiet the voices, but it caused a range of problems for her.
	There is a place for compulsory community treatment orders, but it depends on the individual. That was the message that came loud and clear from service users in Hackney. Interestingly, the overriding view of the service users that I spoke to was that, when someone needed police involvement in their case, there was therefore a strong case for compulsory treatment. When I spoke to people—not just in Hackney—in the course of my research it was interesting to note that, in effect, compulsory treatment currently exists and is allowed under case law. Under section 2 of the 1983 Act, people can be detained for 28 days, and under section 3 for six months, in hospital. But then they can be released on long leave. Long leave presents people with the possibility that they may be once again admitted to hospital. In effect, clinicians are addressing the difficulty of not having compulsory community treatment orders by finding ways through that, through case law. If we get things right in the Bill, it will make it easier for clinicians to provide that option and that choice.
	Talking to professionals, they said that, depending on the relationship the team had with different individuals, the option was sometimes sold as a method of support and sometimes it represented the strong arm of compulsion that was necessary to ensure that people got the treatment that they needed. I have already quoted the consultant who talked about a section being an act of kindness. He and others I spoke to who deal with the issue of sectioning and compulsory treatment on a daily basis believe that, in place of hospital, compulsory treatment orders are a useful and important option, as long as there are safeguards. I am sure that, in Committee, we will look in greater detail at those safeguards. The consultant that I quoted went on to say that the paperwork involved in sectioning was a great discipline for clinicians to justify their decision. I hope that, in any future compulsory treatment that is introduced, that will equally apply.
	Among approved social workers and community psychiatric nurses, there was concern—it is a concern that has not really been addressed so far in the debate—about the risk to staff of applying compulsory treatment in the home. I hope that the Minister will look into that. It may not be something that comes up in the precise, narrow aspect of the law that is contained in the Bill, but it is nevertheless an important issue. If we are to introduce a Bill that is workable, we need to consider how compulsory treatment will apply. It may be that, in a lucid moment, the patient is aware and wants to have the compulsory treatment, and that the family and other carers may support that. However, if there is an issue about how the treatment is applied in a patient's home, for example, we need to look carefully both at the rights of the patient and the safety of the staff involved. It is clear from talking to both patients and professionals that it is chaotic people who prefer self-medication, but then do not take it. They are often at great risk themselves, but they also put staff at risk.
	I want to highlight one example from the point of view of residents in my constituency. A tenant leader rang me in some distress because a neighbour of hers in a small estate was behaving rather erratically. It was clear that the individual had mental health problems. The neighbour was not judgmental. She herself had suffered from mental health problems in the past. At one point, though, the individual was running round the estate with no trousers on. In a worst case scenario, without proper treatment in the community or in hospital, that could have led to the individual being put on the sex offenders register. As far as any of us were aware, that was not the issue for that individual. It seems that sometimes compulsory treatment can protect a patient from worse scenarios and perhaps inappropriate criminal treatment. That is important.It is in the best interests of the individual, his neighbourhood and the other people he has contact with that he gets the treatment he needs. That is not to say that the crisis teams and the current approach to sectioning are not important as well. I pay tribute to those who work in the crisis teams in Hackney, who deal with the sharp end of the issue.
	The other key issue that I want to touch on is advocacy. I feel strongly about this matter, partly because of my experience in a different area as an advocate for someone with a learning disability and my awareness of the difficulties of getting through the system. I have not really got time to go into the issues of advocacy in general, but, particularly in relation to the compulsory treatment element of the Bill, it is vital that advocacy is included. I give the Minister notice that, if I am lucky enough to serve on the Committee, I intend to table amendments to try to make sure that advocacy is better enforced and part of the Bill.
	Professionals agreed with me that there was a need for more advocacy, although interestingly they had different views about what advocacy should be. Under the Mental Capacity Act 2005, Hackney was granted only £40,000 for the whole borough for advocacy. Clearly, there is a resource issue involved as well. If we make sure that advocacy is written into the Bill—to protect patients who are having compulsory treatment—we should also make sure that the resources follow. That is important. In Hackney, as well as the need for mental health advocacy, many mental health patients have complex needs in relation to language and literacy. Mental health advocacy in a constituency such as mine is particularly important.
	The East London and The City University Mental Health NHS Trust is currently working to give service users a greater say in their own treatment. That is clearly the best form of advocacy. But the Revolving Doors Agency—I should declare an interest, because my husband is a patron of the agency—says that half of the people that it is involved with are dealing with six to 10 agencies. Its view is that a lot of people in the criminal justice system are there not primarily because of their mental health, but because of the level of chaos in their lives created by their health needs. For example, they have no GP so therefore no incapacity benefit. Without incapacity benefit, they have no housing benefit. With no housing benefit, they have no hostel or they lose their homes. A lot of things are missing in the system if we do not get that advocacy in place. I hope to expand on some of these issues in Committee.

Hywel Williams: I have a long-standing interest in mental health having recently been a member of the Joint Committee that found the Government's 2004 draft Bill to be "fundamentally flawed." I was involved in the education and training of social workers for 15 years and, before that, I was a mental health social worker—one of the first to be approved under the Mental Health Act 1983. Methuselah-like, I also worked under the Mental Health Act 1959 for seven years and sectioned under the very old system. I have applied for compulsory admission many times, including while working in extremely difficult circumstances as a member ofan out-of-hours night duty team. In my opinion, compulsory admission is essential in some circumstances, but it is a frightening and demeaning experience for the individual concerned and often has profound effects on professionals, sometimes with regard to their physical safety.
	Almost any attention to mental health is welcome. I really do not want to hear the resigned admission from professionals that mental health is yet again the Cinderella of the NHS. After all, Cinderella got to go to the ball and the prince to boot, but that is not what has usually happened in mental health. New spending, some of which the Secretary of State outlined, is welcome, but in Wales, as I pointed out in an intervention, we are still far behind the situation in England, with some people reckoning that we are four years behind. We still have some Victorian facilities. For decades, mental health has been denied proper resources that would turn the promise of new drug and behavioural treatments into a reality of a sustainable life in the community for people with severe mental problems. The reform of mental health legislation is thus long overdue. After all, Professor Richardson, who convened and ran the specialist group, began her work in the last century—more than eight years ago.
	I share the general disappointment of the Mental Health Alliance and others about the Government's successive efforts to formulate a worthwhile and workable Bill. After all, the draft Bills—miraculously, almost—managed to unite nearly all interested parties in opposition, including the royal colleges, Hafal, which is the mental health alliance in Wales, the British Psychological Society and the local Mind groups that I consulted in the Rhymni valley and in my constituency in Gwynedd. They were all against the 2004 draft Bill, which one gentleman described as a "mad axe man Bill". Others complained less colourfully that the Bill, at least as it was then framed, might just about calm some of the headline writers.
	As we know, stranger murder, which is so beloved of the tabloids, is thankfully very rare. The number of homicides has gone up over the past 20 years, but, as was pointed out earlier, the proportion of homicides committed by people with mental illnesses has remained constant. However, when there is any assault involving a mental illness component, a great deal more needs to be done to attend to the victim's needs, or, sometimes tragically, the needs of those who are bereaved. I say that as someone who represents a family that has suffered in one of the most high-profile cases, which is often cited, but cited thoughtlessly. I would, however, apply the same principle of care for the victim to cases that do not have such allure for journalists of a certain type.
	The focus of the 2004 draft Bill was compulsory detention and treatment, as is the case with this Bill, along with community supervised treatment. The vast majority of people with mental problems are in no need of detention or compulsory treatment. They pose no danger to anyone except sometimes, tragically, themselves. Rather, they face the problem of accessing assessment and treatment in the first place. Hafal correctly points out that there is a right to assessment in Scotland—I leave that thought with hon. Members. However, this long-expected Bill, which it is assumed will last for 25 years, does nothing for the vast majority of people with mental or emotional problems. In that respect, the Bill is a colossal lost opportunity and, worse, it risks stigmatising such people.
	The Government seem to presume that it is possible more perfectly than is the case to identify those who constitute a danger to others so that they can be detained. As the Royal College of Psychiatrists points out,
	"the prediction of risk whether done by actuarial or clinical methods is at best an inexact science".
	The Department of Health states that in the past eight years, there have been about 400 homicides in which mental illness has been a component. However, about a third were carried out by people who had been judged not to be a risk just days earlier—this is not an exact science. I need say only that the vast majority of professional people in the field do not share the Government's presumption. Indeed, if the Government's intentions are enacted, we will run a real risk of detaining a number of people who do not constitute a risk to others, while having no guarantee that some of those who constitute a danger will not be out in the community. That would be the worse of two worlds.
	Much has been said about treatability, and the treatability test is there for a good reason. Treatment has developed, and cognitive behavioural therapiesand assertive outreach are employed by talented individuals. However, it is clearly the view of professionals involved that the treatment of personality disorders is usually not possible. Incidentally, I fear that more coercive measures will have the effect of putting off some people from accessing mental health services in any way at all. Such measures might thus have a perverse effect.
	I have seen at first hand the dehumanising and institutionalising effect of detention in a mental hospital with no therapeutic effect. We have already been there and done that. The advances in drug therapy in the 1950s allowed large hospitals to be closed. However, their closure was also driven by a humanitarian appreciation of the pointlessness of the experience suffered by many long-term patients. Many lives dribbled away to no point, such as those of seven ladies whom I met one day in the back ward of a hospital. They had clocked up between them more than 350 years of hospital life for being moral defectives—for having babies out of wedlock in the 1930s.
	If we are to admit people to hospital against their will when they are not capable of being treated, or at least deriving a therapeutic effect, the condition of some who are untreatable on their admission might not change throughout their detention. On what possible basis could they be discharged if there was no change or the treatment did not work? Would we not be in danger of locking people up indefinitely? As Professor Richardson said, we are in danger of compulsion being a lobster pot—easy to get into, but very difficult to get out of. I fear that the Government's proposals will lead to people being detained who are then unable to be treated and discharged. In this case, the Government need protection from their own folly.
	Compulsory supervised treatment in the community should be possible only when appropriate treatment is available. That is an especially important point for rural Wales—and, no doubt, elsewhere—because of the remoteness of treatment centres. Complying with a community treatment order for a person in a city, where the treatment centre might be a journey bybus of only a few miles, would be quite a different proposition than doing so for a person in Pwllheli, in my constituency, where the local hospital is 30 miles away, or even in Aberdaron, which is 17 miles further on. The same could be said for much of rural north-east and south-west Wales, as well as rural Monmouthshire.
	Other aspects of the Bill have a particularly Welsh dimension. For example, there is a disparity between the thrust of the Bill and standard 2 of the Wales national service framework, which is titled "Service user and carer empowerment".
	I hope that the Welsh Assembly will ensure that communication through the medium of Welsh willbe available. It is a long-established principle that someone before the courts in Wales should be able to use Welsh "without hindrance", to use the formulation of His Honour Edmund Davies. People covered by the Bill should be able to use Welsh freely because freedom itself might be at risk. Equally, in the case of compulsory detention, a full apprehension of the meaning of words and the way in which they are used will be essential because someone's freedom might be at risk.

Andrew Gwynne: I appreciate the opportunity to speak in this debate, Mr. Deputy Speaker. I very much welcome the Government's proposals to reform the treatment of people with severe mental illness. I recognise that this is a difficult area in which to legislate, given the necessity to meet the needs of many different groups, but I believe that the Bill will make treatments more successful.
	Some Members of this House and the other place have criticised aspects of the Bill, especially the reforms to enforced detention and to community treatmenton the grounds that they blur the divisions between patients' rights, patient care and public safety. However, I would argue that we will never adequately resolve those complex issues unless they are discussed and understood together.
	One of the overriding reasons why the area is so difficult is that any legislation that we pass will affect so many distinct groups in our constituencies: patients, patient groups, medical practitioners working in GP surgeries and hospitals, our local authority social services working in our communities, and the general public. Taken separately, my instinct is to take account of the individual rights of all involved as far as possible, but with so many groups to accommodate and because of the nature of this area of law and the need for compulsion, it is our job to take an holistic approach to scrutinising the Bill, rather than to concentrate on the concerns and rights of any single group in isolation.
	The rights of patients to refuse treatment must be balanced with patients' long-term interests and the interests of the public. Given the degree of complexity, all mental health legislation is inevitably a compromise. The 1983 Act was a compromise; the medical norms that have developed from that Act are certainly compromises; and the Bill, if it becomes law, will also be a compromise. What we must ensure is the freedom of local practitioners to work in multidisciplinary care teams, the freedom of GPs and psychiatrists to form a judgment based on their relationship with their patient and, crucially, the freedom of the patient to have easier access to mental health tribunals—something that my right hon. Friend the Secretary of State said the Government would work towards as a priority.
	Freedom on the ground will always induce fear that the powers will be misused. We cannot escape the fact that in this area of law such fears are inevitable, but what we are discussing is a system that allows the wishes of mentally ill patients to be overridden for a period by their perceived needs. By broadening the criteria for compulsion, the Bill would allow clinicians the freedom to work across the individual health problems of a patient. Psychiatrists could impose treatments regarded as appropriate, rather than only treatments that are likely to alleviate the specific severe condition of the patient. That is an important change, because it would allow psychiatrists to provide treatment for one mental health condition with the hope of alleviating another. It would, for example, be left to clinical staff to decide whether it is appropriate to treat patients who cannot be cured of their personality disorder, but who might benefit from the treatment of their depression or anxiety. With the correct safeguards, which the Bill provides, such powers give clinicians the freedom to provide better treatment for the sake of the patient and of others.
	The Bill is not about turning our doctors into jailers, as has been suggested in the other place; it is about giving front-line medical staff the flexibility to provide the treatments that they think are best. Opponents of the reform ignore the fact that mental health legislation is permissive: it allows doctors to do what they think is correct and appropriate in the circumstances. After all, no reform that we make can override human rights legislation that gives clinicians the final say.
	Supervised community treatment orders are the second major innovation in the methods by which clinicians could care for their patients. If we want to find a balance between patients receiving their care in the place that they feel most comfortable and medical practitioners being able to ensure the continuation of treatment so that patients are not condemned to repeated periods of ill health and hospital stays, we require a model for community supervision. Some have argued that treatment should be entirely for the benefit of the patient and that threats to the wider public should be dealt with by the criminal justice system, not by doctors. I would argue that there is a role for doctors to impose treatment on those who pose a danger to their own health and that of others, and that doctors are best placed to make such decisions. My fear is that if patients are not able to receive their compulsory treatment in the community—treatment imposed for the protection of their own health—clinicians will continue to be forced either to retain patients in hospital, or to risk the decline of their patients' health in the community.
	Increased care in the community will, of course, be a challenge requiring adequate investment in local authority social services and multidisciplinary care teams, but the Bill gives us the opportunity to take great strides in improving mental health care in the community and providing those receiving compulsory treatment with a great say in how and where they receive it. If we are concerned about discrimination against the severely mentally ill, it is the Government's duty to find a way to enable those receiving compulsory treatment adequately to exercise such choices. It is also the Government's duty to allow patients to receive their treatment with the least disruption to their lives. Supervised community treatment would allow greater confidence that when patients leave hospital, treatment regimes will be adhered to and the patients will not be made the subjects of repeated readmission to hospital and periods of in-patient care. It is vital that the choice is offered honestly and that past failure to adhere to treatment in the community is not made a precondition of a supervision order.
	The Bill also redefines the key professional roles involved in care, allowing a greater degree of valuable multidisciplinary care to take place in the community. The introduction of the roles of responsible clinician and approved mental health professional will allow a range of clinicians from the fields of nursing, psychology, occupational therapy and social work to perform roles that are currently restricted to consultant psychiatrists. That will greatly strengthen the multidisciplinary model of care that has emerged in mental health services in recent years and will allow clinicians to work across disciplines in the way thatis most appropriate to the patient. That view isstrongly supported by Amicus, Unison, the British Psychological Society, the Royal College of Nursing and the British Association/College of Occupational Therapists, which represent many of the multidisciplinary clinicians and carers who, under the proposals in the Bill, would lead such care.
	I fully understand the fears of some local authorities, including Tameside and Stockport councils, which serve my constituents, that the changes might prove to be expensive. It is vital that resources be made available for reforms to local social care policies, but I am confident that the proposed changes to the legislation will be in the best interests of our constituents who are in need of community care for severe mental illness.
	What my right hon. Friend is proposing is that clinicians should be able to offer supervised community treatment in England and Wales as a matter of course, thus not having to wait until their patients have suffered damaging and repeated health decline in the community. As I have argued, we should not forget the aim of mental health law, which is to allow mandatory treatment to be given where necessary for the sake of the health of the patient and the safety of others. There is little point in such legislation if it does not enable clinicians to provide beneficial care to their patients without disruptive breaks in treatment. It is also important not to be transfixed by an orthodox interpretation of individual human rights. The short-term right to refuse treatment and the long-term right to receive appropriate care will often conflict in cases of severe mental illness.
	A balancing act will always be necessary in mental health law, but the Bill promoted by my right hon. Friend the Secretary of State offers us the best balance. There can be no doubt that that the law needs to be modernised. Widening the scope for treatment and allowing compulsory treatment in the community, as well as in hospitals, will benefit patients and communities alike. That is why I shall support the Bill tonight.

Ann Coffey: It is not surprising that the Bill has proved controversial. After all, we are dealing with contentious issues of liberty and personal responsibility, and we have been asked to determine in what circumstances anyone with a mental disorder should be detained against their will. Those and other issues have been the subject of debate since the Government announced their intention to introduce new legislation in 1998.
	During the Bill's controversial passage through the other place, their lordships sought to address those problems where they still believed that an individual's human rights were at issue. As elected Members of Parliament, we need to take into account, too, legitimate public concerns about safety. However, given the importance of this area of legislation, it is essential that we find a way forward that addresses the concerns of all parties. We need legislation on the statute book that is, and will be, suitable for our communities in the 21st century. A stand-off between the two Houses on the issue would not be helpful, and we can achieve our aims by considering the way in which the Lords amendments would work in practice, rather than in principle.
	I am not a lawyer, but I trained as a psychiatric social worker, and worked as such for many years before moving on to different things. I should like to consider the Bill from the perspective of the approved social worker—or the approved mental health professional under the Bill—who sets up and undertakes with doctors the assessments that determine whether or not someone needs to be admitted compulsorily under the Mental Health Act 1983. Approved social workersare highly trained and skilled professionals who act independently and are personally and legally accountable both for their decisions and for the safety and well-being of the service user who has been sectioned until they are accepted on a ward by nursing or other staff. How will the amendments to the definitions of mental disorder and treatment for it help or hinder that process of assessment?
	I have looked at the original Bill and the Lords amendments in relation to the criteria for compulsory admission from the community, particularly the issues of "medical treatment" and "impaired" decision making. The original Bill talked about the availability of "appropriate medical treatment", whereas the Lords amendment used the words,
	"medical treatment...likely to alleviate or prevent deterioration"
	in the patient's condition. In both cases, the term "medical treatment" has the same broad meaning. It includes medication, nursing care, habitation and rehabilitation, as well as psychological treatment or support. One focuses on the notion of availability of "appropriate" treatment, and the other on its likely benefits, but are those two notions very far apart? If the treatment available would not help the patientby alleviating or preventing deterioration in their condition, can it be said to be appropriate? It appears to me that the issue involves interpretation rather than the words themselves.
	The Lords have also inserted a new condition into the provision on criteria for formal admission for consideration in the assessment:
	"because of his mental disorder, his ability to make decisions about the provision of medical treatment is significantly impaired",
	which, of course, refers to the patient. In my experience, the amendment reflects exactly what already goes on with Mental Health Act 1983 assessments, where doctors and approved social workers use their skills and knowledge to ascertain through the assessment process whether the person before them is, in effect, unwell and in need of treatment or care, or whether the person should be given choice and take responsibility for their actions and decisions.
	I want to provide the House with an example. I spent last Wednesday in the company of approved social workers and observed a mental health assessment in a police station. The gentleman concerned had been picked up by the police at 8.30 after a complaint from a neighbour, and the forensic medical examiner expressed concerns about him and asked for an assessment under the 1983 Act to determine whether he needed assessment or treatment and whether he was fit for interview. During the mental health assessment, he was asked questions to establish the nature of his relationship with the complainant and his understanding of why he was in a police cell. The professionals probed his belief system and his emotional state and sought to determine whether there was an underlying psychosis, depression or anxiety state and the level of risk that he posed to himself, to the person who had made the complaint against him and to the wider public. Although the professionals were clear that the man had a level of mental disorder, when they discussed the issue between them, they concluded that it was not so bad that they needed compulsorily to detain him and that he should receive treatment on a community basis. The outcome of such an assessment is likely to be the same, whether or not the Lords amendment is accepted.
	As I have said, we can set the boundaries within which professionals make their decisions about assessment, treatment and responsibility of people who experience mental disorders. We can also—the Government, to their credit, have done this—regulate to ensure that the professionals who are involved in those essential decisions have the knowledge and skills to make informed, professional decisions. Having ensured that, we must then trust the professionals to make such decisions to the best of their abilities. However, we must also ensure that the professionals whom we ask to undertake assessments on our behalf and on behalf of society as a whole have the resources to do so safely and in a timely manner.
	Department of Health figures show that 27,353 patients were compulsorily admitted from the community to NHS facilities and independent hospitals under part III of the Mental Health Act 1983 and other legislation in England in 2005-06. As I have said, the approved social worker is responsible for organising the assessment, but the responsibility is greater than that—they have to apply to courts for a warrant if the person will not let them into their home to undertake an assessment, make judgments about whether to involve the police in the assessment process, consider how quickly the assessment should take place, consult other professionals and family members about their views and, ultimately, make an independent and balanced decision whether admission to hospital is, given all the circumstances of the case, the most appropriate way forward. They decide whether or not to apply for a formal admission, and if they decide not to apply, there will be no admission. The process of admission can be fraught, but representations from approved social workers via the British Association of Social Workers and the ASW national leads network suggest that the situation is being made worse by problems with the way in which resources are managed.
	I have mentioned my day with the approved social workers in central London, but I did not mention that when we left the office last Wednesday there were two other mental health assessments that had been waiting since the previous Thursday, which was before the bank holiday weekend, for police support to be available to enable them to take place. That was because the person requiring assessment was known to have been aggressive or had used threatening behaviour, and the ASW and the doctors could have been at risk without police support. There is also the issue of perhaps having to convey an unwilling patient to hospital. That delay of almost a week for police support could have had very serious consequences for the people who needed assessing and those around them. Other issues are involved in the assessment process, such as the identification of the bed and the availability of ambulances.
	The British Association of Social Workers points out that although the individual approved social worker has responsibility for managing the assessment process, for making informed and professional decisions about whether to admit someone, and for the safety and well-being of the patient from the time that they sign the section papers to the moment the person is admitted to hospital, the resources they need to complete their tasks are not within their control locally. The Government have said that those issues, including police time, are best dealt with through local arrangements. I hope that in recognising some of the present difficulties there will be consideration in Committee on how to give guidance about what local arrangements Ministers believe should be in place to protect the individual and the public by ensuring that where admissions to hospitals are necessary they happen in a safe and timely fashion.
	The Government have made great progress in the provision of mental health services—not an easy area in which to legislate or to work. I hope that the Bill has a constructive passage through the remainder of its legislative process.

Martin Horwood: The other place has a reputation for well-informed debates, but I have been struck by the level of expertise that hon. Members have shown today, sometimes speaking from painful personal experience.
	I pay tribute to all those who work in community, day-care and hospital mental health services in my constituency and elsewhere. They work very hard in a challenging area of health care where their occasional failure is often leaped on by an unforgiving media while their frequent success is much more rarely mentioned.
	I share many of the concerns of other hon. Members, including my hon. Friend the Member for North Norfolk (Norman Lamb), about the initial version of the Bill. I have been strongly lobbied on some of its provisions by constituents, one of whom said:
	"Please do whatever you can to stop the Government's proposals in their tracks and get a law for England and Wales that's as fair as the law in Scotland."
	However, as the Minister knows, I also share some of the concerns that led to the Government presenting the Bill in its original form, particularly in relation to people with personality disorder, who have suffered from the fatal combination in the Mental Health Act 1983 of very specific definitions of mental disorder and illness and the treatability test. That has led to people with personality disorder being denied treatment, whether in line with the law or, as the hon. Memberfor Buckingham (John Bercow) noted, based on a misguided view that the condition cannot be treated.
	The current law is, by common consent, flawed, but the need to guard the civil liberties of some of the most vulnerable citizens in our communities means thatany amendments to it must be carefully worded. That will be a difficult task, particularly in the case of personality disorder, even the definition of which is difficult to grasp. In the words of Mind,
	"Slotting people into neat categories is almost impossible, because each individual is unique and personality is very complex. It's a mistake to assume that giving people a diagnostic label means knowing more about them, and it's too easy to use these terms in a judgemental way."
	That was certainly so in the circumstances that applied in the case—now, I am afraid, the very public case—of one of my constituents, a young man called James Green. It seemed to me that he was unable to access the treatment that he needed because, in a sense, he did not have a proper mental illness, having been diagnosed with personality disorder. I should like to take a moment to pay tribute to the care, dedication and perseverance of the Green family—Les and Jackie, James's parents, and particularly Daniel, his brother, who has championed his case tirelessly.
	James had a long history of difficult, sometimes very aggressive behaviour involving self harm and of threats to harm his family. As he grew older, he increasingly said that voices were telling him to harm himselfand his parents, and he wanted to be admitted to somewhere where he would feel safe. Again and again, though, the situation was that his medication was reviewed and even if he was admitted for a short time he was returned to his family, sometimes with community support but making life increasingly difficult for them.
	In July 2005, James set fire to his house, endangering the lives of his parents and his neighbours. He was prosecuted for arson and recklessly endangering life and sentenced to seven months in prison. That was the beginning of a prolonged relationship with the criminal justice system.
	Court-appointed psychiatrists examined James repeatedly and diagnosed personality disorder. An assessment in December 2005 clearly concluded that he did not have an acute, chronic or serious mental illness but that he nevertheless ran a "high risk" of harming himself and others. Another stated,
	"no mental illness, borderline learning difficulties, personality disorder. Immature, impulsive, substantial risk of re-offending/self-harm."
	Yet the judge in the case found it almost impossible, despite repeated adjournments to seek professional advice, to locate an appropriate setting where James could receive treatment.
	During that time, I met the partnership trust with James's brother, Daniel, and it said that there was a legal framework for treating mental illness but that James appeared to fall outside it. On one occasion, it stated that it believed it
	"most appropriate for any consideration of his health and social care needs to be seen within the context of his current offence and resolution by the courts."
	It became clear to me that Gloucestershire probation service and Her Majesty's prison at Gloucester were familiar with dealing with people with personality disorder.
	I discovered a psychiatric morbidity survey among prisoners, which revealed that 78 per cent. of male remand prisoners had some form of personality disorder. We have effectively handed over the care of many people with personality disorder to our prisons and our probation services.
	It is typical that James's case reaches something of a climax tomorrow when he appears before a judge for sentencing, not before a doctor for treatment. However, the family hopes for the outcome that his assessment and treatment at a unit called Kneesworth house in Cambridgeshire will become a more permanent arrangement. James has—eventually—benefited from treatment, which has been more psychological than pharmaceutical. I compliment the staff at Kneesworth on their work with him. They have demonstrated two fundamental truths.
	First, no one should be excluded from treatment because of the form of words used in their diagnosis. The Bill, even as amended, appears to prevent such exclusion. It is clear that it covers personality disorders. The draft illustrative code of practice, which would not be affected by the amendments, clearly specifies that personality disorders will be covered.
	Secondly, Kneesworth has demonstrated that, even with difficulty and after years of trying, the current system can provide treatment, with a treatability test in place. The Bill, as amended, would provide a much better and clearer legislative environment, in which we all agree that people with personality disorder should get the treatment that they need.
	I said earlier that amendments to law needed to be carefully worded. Such amendments have come from the House of Lords. On the definition of mental disorder, amendment No. 3 stated:
	"For the purposes of subsection (2)... a person shall not be considered to have a mental disorder... on the grounds of... substance misuse... sexual identity or orientation... his commission, or likely commission, of illegal or disorderly acts... his cultural, religious or political beliefs."
	It is difficult to see who could take exception to that. It would not have prevented James Green from obtaining treatment and it does not reintroduce the narrow definitions of mental illness that the 1983 Act contained.
	The amendment on the treatability test would reintroduce the words of the original Act but would not enforce a narrow test. It simply states that, for a treatment to be provided, it must be at the very least,
	"likely to prevent a deterioration in"
	someone's "condition". The condition does not therefore have to be perceived as curable or definitely treatable. The treatment does not have to be guaranteed, simply "likely", to be beneficial. It is difficult to understand how that could possibly have denied someone such as James Green treatment. If that modest test is not passed, how is compulsory treatment distinguishable from detention without treatment?
	In Rethink's rather blunt words:
	"Hospitals are not prisons. If people are detained for non-health purposes, it must be through the criminal justice system."
	The Royal College of Psychiatrists agrees. It described the Lords amendments as "very sensible amendments". It even stated that they would have public support. It conducted a poll in the south-west of England, which found that 75 per cent. of people
	"do not think that people with mental health problems should be forced to have treatment from which they cannot benefit."
	I have talked to not only doctors and psychiatrists but the Green family about the amendments that were tabled in the other place. Daniel Green studied them before I even spoke to him. Neither he nor I can understand why they pose any risk to people with personality disorder getting the treatment that they need. I hope that the Government will realise the potential for building cross-party consensus on such an important Bill.

Madeleine Moon: As many people have remarked during the debate, this is a complex Bill with a history of controversy, compromise and confusion. That is mainly because the plan to introduce a mental health Bill was replaced by the decision to amend the Mental Health Act 1983, and this has clouded the discussion of what the Bill is saying, as opposed to what many people want it to do, to say and to promote.
	I recognise the anxiety felt by families, carers and those with a mental health problem. With at least one in six of the population suffering from depression, anxiety or obsessive compulsive disorder at some time in their lives, one in 22 having a personality disorder, and one in 200 suffering from psychosis, with the resulting loss of contact with reality, mental health issues touch most families at some point and bring them into contact with our mental health services.
	It has been good to hear recognition across the House today of the Government's improvements to mental health services. The range, availability and effectiveness of the services has certainly changed. Years of neglect are slowly being counteracted. I also recognise that an increase in budgets is not the only thing that will improve services. Training, new facilities and new partnerships need time to be put in place and to become effective.
	The Bill has achieved a high profile specifically because of the voluntary sector, which now receives a huge amount of funding to improve mental health advocacy, raise awareness of mental health issues and provide a new range of services. Organisations such as Hafal, the Mental Health Alliance, Mind, and my own Bridgend organisation, Mental Health Matters, are rightly eager to ensure that the Bill will provide the highest level of protection and rights to those who face compulsion at some time in their lives. Like others,I pay tribute to their unending commitment and creativity in providing a range of services to people who are mentally ill.
	Statistics cannot give a realistic picture of the pain, suffering and torment experienced by those with a mental health problem, and by their families and carers. I want to stress that. When considering the Bill, I have borne in mind the fact that, of the 300 people in every 1,000 who experience mental health problems every year in Britain, only six will become in-patients in psychiatric hospitals. In 2005-06, 27,779 patients were sectioned and would therefore have been considered for a community treatment order.
	The Bill relates to how we deal with the limited number of people who face formal admission every year. It is about strengthening patients' safeguards and tackling human rights incompatibilities. It is not about improving access to services, expanding the range of community-based mental health provision, or handling housing problems caused by tenants with mental health problems. It is not about tackling mental health awareness. It must, however, signal the Government's commitment to dealing with all those issues if it is to be effective and to reassure those who use mental health services. While only six of the 300 in every 1,000 people who experience a mental health problem are likely to face compulsion, failure to address these issues will lead to the vast majority of sufferers, and their families and carers, fearing that the services will not be there to meet their needs, to help their recovery, to keep them safe, to enable them to live in the community and to avoid compulsion.
	It has been alleged that the Bill is driven by media stories of murder and other violent crimes committed by people with mental health problems. There are fears that it is heavily biased towards extending the powers of compulsion and control. I believe that many of those fears have been addressed by changes in the Bill, including a list of exclusions, clarification of impaired decision-making and the use of places of safety and time limits in the context of renewal of detention.
	Others have already highlighted the fear and anxieties of families such as one in my constituency. A family member was murdered by her husband, who had a mental health problem. The family were frustrated by a system which they felt left their sister vulnerable. Within a very few years of her murder, her husband was seen in the local community in the company of a nurse. The family felt betrayed and insecure, not knowing whether this man would be in their street, shop or pub. They were angry that they had not been consulted about community rehabilitation plans, or made aware of an appeal to the mental health review tribunal. They, and I, feel strongly that victims' families should have such rights.
	Like others who have spoken, I welcome the duty placed on health authorities to admit children to age-appropriate settings, and to provide specialist assessment and supervision for detained children. My constituency has the highest suicide rate among young males in Wales. I have spoken to parents of young people who are afraid of being returned to adult wards that are frightening and threatening and increase their vulnerability at the time of greatest need.
	Many years ago I lodged an advance directive with my GP. I set out the limits to treatment that I wanted to establish in the event of my losing capacity. I believe that those who are mentally well should be able to write an advance directive nominating the person whom they wish to act as their nearest relative, primary carer or advocate, specifying people with whom information can be shared by medical practitioners, and giving directions about future treatments. Such documents should be taken into account by those making decisions on the provision of treatment and on compulsion. An advance directive gives individuals a voice at a time when they may well be unable to speak for themselves in their own best interests, and can reduce anxiety for patients' families and friends.
	For a time I managed a specialist health and social services project for people with dementia. Joint assessments were made by the community psychiatric nurse and me when people were referred to our service. Our assessments and conclusions were different, reflecting our different training and perspectives, but they were better assessments for being joint. I fear that there will be a risk of "medicalisation" of assessments if the social workers and two doctors are replaced by a range of health professionals and a responsible clinician, especially if they work in the same mental health team. I hope that care will be taken in the training provided for that new role, and that advocacy of the service user's perspective will not be lost.
	It is in the best interests of the Bill for the fundamental principles to be written into it, and the status accorded to the code of practice clearly identified. I believe that that will reassure users, carers and mental health professionals about the ethos on which mental health services are predicated. It will provide evidence of the Government's commitment to improving services consistently in line with those principles, and demonstrate their commitment to the mentally ill while also protecting the public.
	As I have said, the Bill deals only with the very small percentage of people who require compulsion. We should not forget that it is aimed at that small percentage of people with severe mental health problems. It is sad that much of the debate, and the anxiety that has been created, relates to issues outside the areas covered by the Bill. We have sometimes been sidelined into discussing things that are missing from our mental health services, rather than the good aspects of the Bill and the safety and security that it provides for people at their most vulnerable. I trust that the anxieties expressed by Members today will be discussed again in the Committee on which I hope to serve.

Charles Walker: I am afraid that I will not be able to do the subject justice, because we have heard excellent speeches from the hon. Members for Rhondda (Chris Bryant) and for Caernarfon (Hywel Williams) and from my hon. Friend the Member for Buckingham (John Bercow). However, I shall try my best.
	Ever since I came to this place, I have taken an interest in mental illness. We all have our own reasons for pursuing such an interest, but I am always touched and humbled by those people who come up to me and thank me in a quiet way for being their voice and for raising their concerns. Very often, people with mental illness feel marginalised and feel that there is no one out there listening to them.
	That was brought home to me when I visited an outreach centre in Cheshunt where, after a roundtable discussion, the director of the centre said that one of the patients would like to have a word with me in private. I went into a room and met a gentleman who suffered from schizophrenia. He wanted to educate me about the illness. I was moved by the conversation—he did not need to validate himself to me—because he said that if someone had cancer or heart disease it would not define them. They would still be Charles with cancer or with heart disease, but he was all too often referred to as schizophrenic. I thought that that was very upsetting.
	Mental illness makes many MPs feel a little uncomfortable. I have heard Members talk in the Chamber about personal experiences, but I think that I am right in saying that never in the history of Parliament has a sitting MP admitted to having a mental health problem. That was touched on by the hon. Member for Windsor (Adam Afriyie). I often wonder why there is a reluctance to come forward.
	Many MPs who want to discuss a personal issue must pause for thought and perhaps the following things might occur to them. They might think that mental illness is perceived in our society as a huge weakness. They might wonder how their association would react. "Would it throw a supporting arm around me or would it move to deselect me? How would my children fare in the playground if I, as an MP, admitted to having a mental illness? Would they be teased or possibly even worse? How would the local and national press react? How would my constituents react? What would be the response from my colleagues in this place?" All these factors might weigh on an MP before they discuss a personal issue.
	We understand that mental illness does not sell well on the doorstep. If we were talking about heart disease or cancer, the Chamber would be much fuller. I am sure that there are MPs who, in their hearts, would like tobe here speaking up for the mentally ill against what might become a fairly oppressive piece of legislation. However, they are risk-averse. What would happen if they had the courage to speak up and one of those isolated tragedies occurred in their constituency? Would they be pilloried by the local press for supporting "loonies and nutters"? Those are not my words, but they are words that are used far too often by the media to describe sick people who deserve our compassion.

Charles Walker: I have paid fulsome tribute to the speeches of Members this evening but my views are little different from those of the hon. Lady and I hope she will accept that.
	I am concerned that we may be deliberately, or mistakenly, pandering to the tabloid press and validating some its more screaming headlines. I did some research; the  Daily Mail had the headline
	"Knife maniac freed to kill...Mental patient ran amok in the park",
	while  The Sun had
	"Violent, mad. So docs set him free. New community care scandal."
	They are appalling misrepresentations of people with mental illness, and it does our media a great disservice that they persist in bringing them forward. However, I believe that we live in a civilised society and that our Government will in their heart not want to regulate in this area to satisfy the tabloid press.
	The media reporting of mental illness is shameful. The Royal College of Psychiatrists has stated:
	"The media's obsession with reporting cases of mental health patients who become violent has seriously distorted the truth. Mental health is not a predictor of violence against others for almost all diagnosis".
	It continues:
	"There is a slightly higher risk of violence with a diagnosis of schizophrenia but this is insignificant compared with the relationship between other conditions and violence—alcohol consumption being the main one."
	Before I leave the subject of the press, I wish to say that it is unacceptable at a time when we have consigned phrases such as "cripple" and "retard" to the scrapheap that many of our leader writers still think that it is legitimate to use words such as "nutter" and "loony". Much of the media's reporting can be put down to laziness and avarice to keep their circulation up.
	Recent research by the Glasgow University Media Group into the attitudes of senior production staff to the reporting of mental illness resulted in the following conclusions—unsurprisingly:
	"News and features emphasise the newsworthy rather than the worthy. Stereotypes are therefore enormously useful and they short circuit the need to spend time understanding a topic. They simply follow a rapid tried and tested formula which is known to work commercially."
	Commenting on the research, Graham Thornicroft, head of the health service research department at the Institute of Psychology said:
	"This is consistent with the tendency for people with mental illness, when not shown as violent predators, to be allocated to the category of helpless victim."
	One of the tragedies of the Bill proposed by the Government is that there was not much compassion in it. There is a lack of willingness to challenge some of the distortions of mental illness peddled and promoted by the media. I have a great deal of time for the Minister—I have met her privately on a couple of occasions to discuss my concerns about mental health problems in my constituency— but in her ministerial press release of 1 March, after the Lords amendments were passed, she mentioned public protection no fewer than six times. What she mentioned was public protection—not the interests of the patient, but the interests of the public. Public protection is a consideration, but it should not overshadow the main purpose of any mental health legislation, which is the care, safety and well-being of patients.
	Let me give a further quote from the Royal College of Psychiatrists:
	"The law should seek to reduce stigma and discrimination against people with mental illness. Wherever possible the principles governing mental health care should be the same as those which govern physical care enabling people to feel able to seek help early, to ask about their fears and difficulties, without fearing scorn, humiliation or loss of status, freedom, job and friends is the best way to bring about improvement in their health."
	I will not dwell on statistics, but it is worth pointing out that people in this country are almost four times more likely to be killed in a motor traffic accident than to be murdered and 80 times more likely to be killed in a motor traffic accident than to be killed by someone suffering from schizophrenia. In our tolerant society, we cannot live without risk and still call our society free. With the best intentions in the world, the Government cannot legislate to create a risk-free society.
	It appears that a different set of rules apply to the mentally ill—that the normal rules relating to limiting civil liberties and rights are suspended. Let us imagine what would be the outcome if we were to follow the advice offered in an article in  The Daily Telegraph today. The article is entitled:
	"MPs should vote to save innocent lives".
	It is written by Philip Johnston, who writes:
	"If this Bill will save lives, then Parliament has a duty to support it."
	I can think of a couple of Bills—unattractive Bills—that might save lives, and which might have been brought forward in a less enlightened time, such as30 or 40 years ago. We could introduce a Bill to ensure that people with AIDS are locked up so that they do not pose a public risk. That would be unattractive, but I am sure that it would save a few lives. We could go out and round up young black males in Peckham, which might save a few lives in that area, but that is an unattractive and unpalatable solution. So why is it that when we discuss mental health we too often separate sufferers from everyone else to whom we accord rights?
	Things have improved for those suffering from mental illness and I would not be churlish enough to deny that, but the Bill is the acid test, because it deals with some difficult issues. Of course people who pose a danger to others should be given treatment and looked after. But 79 members of the Mental Health Alliance would not be supporting the Lords amendments or opposing the Government's original drafting if the Bill would not massively extend the scope of the existing provisions to people who for good reasons should not be covered by the new legislation. I cannot believe that the 79 members of the MHA have got it wrong, or that the BMA and the Institute of Psychiatry have got it wrong, but the Government have got it right. Surely the Government must recognise that when they are in a minority of one it is time to look at the issue again. The MHA is purely dedicated to looking after the interests of those who suffer from mental illness and I take their advice very seriously.

Diana Johnson: I listened with interest to the hon. Memberfor Broxbourne (Mr. Walker), especially when he questioned whether a Member of Parliament had ever admitted to having a mental illness. I thought of Winston Churchill, who admitted to having the "black dog" of deep, dark depression—

Diana Johnson: In any case, Winston Churchill achieved a great deal in his career as a Member of Parliament, and in recent weeks and months various people in public life have said that they have had mental health problems, but they too have achieved a great deal.
	I was a member of the Mental Health Act Commission for several years and visited people who were detained in in-patient facilities in London and the south-east. The experience of meeting people whohad been sectioned, received compulsory treatmentand lived in wards—some of them in appalling conditions—was a salutary lesson for me about how we treat people with mental illness. It is important to remember, as my hon. Friend the Member for Bridgend (Mrs. Moon) said, that only a very few people end up sectioned and as in-patients in hospital, but they are an important group and we must get their treatment right. For a long time, they have been pushed to one side and not focused on properly. That is why I am really pleased by several aspects of the Bill, including the community treatment orders.
	I am not saying that the care and attention given by NHS staff was lacking in any way, but I saw distressing conditions in some wards in some in-patient facilities where some people found it very difficult to hold themselves together. I remember seeing one person who refused to wear clothes and had to be kept in a room with no furniture and restrained for much of the time, because he was so unwell. We must get the treatment of such people right.
	I raise that point because it is important to remember that in-patient facilities have improved enormously, but the whole thrust of the NHS reforms is about providing care in the most appropriate place for the person. For some people that will be an in-patient facility, but many people want care close to their home, if not in the home, so CTOs will be a real step forward in giving people with mental health problems that option. We want people to receive other forms of NHS treatment close to their homes, as some already do—so why not people who have mental health problems?
	The multidisciplinary approach is prevalent in the mental health field, so it is right that we consider who should make decisions about sectioning people; for instance, amending "responsible medical officer" to "responsible clinician" is the right way forward, asare the provisions amending the role of the approved social worker to include "approved mental health professionals". Such steps will allow psychologists, therapists, nurses and social workers to play a full role, along with clinicians and consultant psychiatrists, and would show that we are taking a much more modern approach to dealing with mental health care, rather than using only a medical model, which is rather old-fashioned.
	In Committee, I hope that we can look again at the provisions on nearest relatives to allow patients the option to nominate the person they want as their nearest relative. The list is too prescriptive at present and the patient is allocated a person. Family relationships are often difficult and the patient may not want their actual nearest relative to speak for them and take important decisions.
	I was pleased that my hon. Friend talked about the advance directive, as it is an important issue, although it may not be appropriate for the Bill. An advance directive allows the patient some dignity; when they are well they can say, "This is what I would like to happen if I am ill again." That is a positive step forward for mental health services.
	It is distressing that sometimes police cells have to be used as place of safety accommodation, althoughI understand why it is necessary. I hope that the Government will reconsider that practice and think more creatively, especially in light of the massive NHS building programme; for example, some of the local improvement finance trust buildings or provision in the acute sector might be used as places of safety. The police need training. I was shocked to find that most police officers do not receive substantive training in dealing with people with mental illness.
	Finally, we need to try to remove stigma. An important development in schools in recent years is the national healthy school standard, a key aspect of which is promoting emotional health and well-being in our youngsters. We should try to raise the issue of mental well-being with our children early on, so that they do not think of mental illness as a frightening, distressing condition to be backed away from. I remember a nurse telling me that if a person has a broken leg the general public will always help; when they see that a person has a physical injury they do everything they can to help because they can see the problem, but if someone has a mental illness, people run away—they do not want to help. We have to try to address that issue with our youngsters in school, by saying that we should not be frightened of mental illness; it is treatable and we can do things to help people. Let us treat it like any other illness and not see it as a distressing, frightening condition.

James Duddridge: It is a pleasure to follow the hon. Member for Kingston upon Hull, North (Ms Johnson) who made a number of salient points, especially about nearest relatives. However, I disagree with her when shesaid, referring to the hon. Member for Bridgend (Mrs. Moon), that the Bill was not the place for considering advance directives. The hon. Member for Bridgend made an impassioned and logical case and I hope that the matter will be discussed in Committee, because it would be wholly appropriate to do so.
	I did not enter the House of Commons with a deep knowledge or understanding of mental health issues, but over the last two years—because of the people coming to my constituency surgery and as a result of my travelling around the constituency—I felt compelled to understand more about those issues and how they were dealt with in the House. Indeed, my first meeting with a constituent in this place was with someone from SUNRISE—Services Users Network Representation in South Essex—a mental health advocacy group. He raised with me problems stemming from the Mental Health Act 1983 and asked when there would be a mental health Bill. I tabled a number of written questions to Ministers on that question and I am glad that we are now having a Second Reading debate on the Mental Health Bill.
	On the basis of evidence presented to me, I was prepared to oppose—and oppose quite strongly—a mental health Bill, but I am now in the somewhat bizarre position of supporting the Mental Health Bill today, largely because of the amendments tabled in the other place. However, I will be deeply disturbed if, as I think and fear will happen, a number of those very sensible amendments are turned down in Committee.
	Looking again to my local area, mental health is covered by the South Essex mental health partnership, whose chief executive, Patrick Geoghegan, does an absolutely fabulous job—

James Duddridge: I am glad to see that the Minister shares my view. In fact, the mental health partnership was one of the first foundation status organisations within the sector. The annual report shows that one of the biggest risks over the next five years is this Bill or Act if it passes through Parliament. If Patrick Geoghegan and the South Essex mental health partnership are concerned, I am certainly concerned. Meetings with organisations such as SUNRISE and more national organisations such as Mind and Rethink have confirmed my worst fears. Visiting a local prison did likewise. The hon. Member for Cheltenham (Martin Horwood) referred to a figure in the high 70s in respect of people in prison with mental health problems. On visiting a local prison, I was told that more than 80 per cent. of the male population were suffering from some form of mental illness. That is truly horrific.
	Many hon. Members have mentioned the mental health partnership and been extremely complimentary about the organisation—or collection of organisations. The partnership believes that the amendments tabled in the other place "significantly improve" the legislation, in contrast to the Minister's assertion that they "seriously weaken" it. With no offence intended to the Minister, I tend to support the view of experienced health professionals over that of politicians. We could say that professionals always have a narrow or biased view, but they are backed up not only by the Mental Health Alliance, but by the Law Society, which has welcomed the amendments, calling them "measured and judicious changes" and urging the Government not to overturn them. Those are two very eminent societies, as hon. Members on both sides of the House have acknowledged, and what they say is surely right.
	Beyond the additional four amendments tabled in the other place, a number of their Lordships spoke about independent advocacy, which has also been mentioned in this House. Independent advocacy was included in the 2002 and 2004 draft Bills, but is missing from the current Bill. I would like to see Ministers bring forward more detailed provisions on advocacy in Committee, building on the work already mentioned by my hon. Friend the Member for Tiverton and Honiton (Angela Browning).
	The hon. Member for Kingston upon Hull, North mentioned the nearest relative and it is important to expand on who can be nominated by an individual, particularly when they are of sound mind. I ask the Government to reflect on tabling amendments to provide that such choices do not have to be brought before the courts. It is important not to have too much bureaucracy surrounding the process.
	In my final minute, I would like to make a point about stigma. Katie J, a local artist, recently invited me to open an exhibition, provocatively named "Sad, Mad and Glad". Katie suffers from mental health problems, but felt a responsibility as a pillar of the community to say that it is possible for people to come out the other side and to talk about mental health problems.
	One concern raised by Members, particularly on this side of the House, is that parts of the Bill may drive people with mental health problems underground. That is the very thing that neither side of the House wants. It is, however, a problem that I fear will be significant.

Tim Loughton: We have had a very good debate, with somevery knowledgeable contributions from no fewer than 17 Back Benchers—I have counted—all of whom paid tribute to local projects, local services and local mental health workers, who do an excellent job, often in challenging circumstances. It has been a well-attended debate, as the hon. Member for Bridgend (Mrs. Moon) said earlier. That might have something to do withthe fact that, from memory, it is the first time in my10 years as a Member that we have had a debate on mental health in the Chamber in Government time. We have had such a debate in Opposition time, courtesyof us.
	We have heard some excellent contributions. We started with the right hon. Member for Sheffield, Brightside (Mr. Blunkett), who is not in his place at the moment. Rather unfortunately, he chided some of the mental health organisations that are part of the Mental Health Alliance, by saying that they were raising false fears among various sufferers of mental illness. As has emerged time and again, the 79 organisations in the Mental Health Alliance cannot have it all wrong. He made a very good point that we should make provision for the families of victims as well.
	The hon. Member for Stafford (Mr. Kidney) made an excellent, well-informed speech, as usual, given his experience from his legal background. He said that there have been improvements in mental health services around his constituency—of course, there have—but the amount of extra money going into mental health services does not match the amount of extra money that has gone into the national health service as a whole. He also said that community treatment orders were relatively new and that therefore it is difficult to derive research from them. They are not relatively new in other parts of the world, particularly the United States, where they have been going for some time and where there is no definitive evidence that they are as effective as the Government are trying to make out.
	My hon. Friend the Member for Tiverton and Honiton (Angela Browning) has enormous experience of this subject, not least with those with learning disabilities, particularly autism. I hope that she will be able to bring that experience to the Committee that considers the Bill; her comments about advocacy were certainly very well made.
	The hon. Member for Hendon (Mr. Dismore), the Chairman of the Joint Committee on Human Rights, referred to some of the concerns that his Committee has rightly raised, and we want to debate them in Committee.
	The House will agree that my hon. Friend the Member for Buckingham (John Bercow) made an excellent contribution. He praised the cross-party expertise in the Lords during the earlier scrutiny of the Bill. He said that the Government appear to be in splendid isolation and made the relevant point that I have been trying to make to the Secretary of State, who failed to grasp it, that we should treat people with a mental illness on no different a level from people who have a physical illness. The natural extension of what the Government have been saying is that someone who has cancer treatment and decides that they do not wish to take that treatment will not be subject to some form of compulsion, so why should we treat people with a mental illness differently? That only engenders the stigma that so many other hon. Members have spoken about as well.
	Many hon. Members also spoke with real passion about very personal experiences, none less so than the hon. Member for Rhondda (Chris Bryant), who rather bravely spoke about his own family's experiences and those of his neighbour. I am sure that many of us will have had similar experiences with constituents facing such problems. What he did not add, however, is why the Bill in its previous form would solve those problems or why the Bill, as amended by the Lords, would fail to do so. There was therefore something lacking from his contribution.
	Again, we heard excellent contributions from the hon. Member for Hackney, South and Shoreditch (Meg Hillier). I have visited the Hackney Mind project, and I know about some of the excellent work that it does with the black and minority ethnic community there and about the very real problems that she has in that part of east London.
	The hon. Member for Caernarfon (Hywel Williams) spoke, as usual, with great knowledge of the subject. The hon. Member for Denton and Reddish (Andrew Gwynne) seemed to say that treatment regimes will be adhered to only because of the compulsion parts of the Bill. I failed to understand that. It seems that the Government follow the rather bizarre logic that people can be guaranteed to get treatment only if we raisethe number of people subject to compulsion. That should not be the way. Those services should be there for everyone, without having to subject them to compulsion.
	My hon. Friend the Member for Windsor (Adam Afriyie) summed the situation up well when he said that everybody in the House is concerned for vulnerable people. The hon. Member for Stockport (Ann Coffey) brought her own expertise as a former psychiatric social worker to the issue. The hon. Member for Cheltenham (Martin Horwood) spoke about personal constituency cases. He has had to deal with some pretty dire cases, as has the hon. Member for Bridgend. My hon. Friend the Member for Broxbourne (Mr. Walker) said that people with a mental illness look to him as a Member of Parliament to provide a voice for vulnerable people, and I am sure that that is true of many other Members of Parliament. The hon. Member for Kingston upon Hull, North (Ms Johnson), who is a member of the Mental Health Act Commission, was another person speaking with great expertise. My hon. Friend the Member for Rochford and Southend, East (James Duddridge) talked about stigmas.
	We have had a well-informed debate, following on from the expertise in the other place. We think that we now have a relatively good Mental Health Bill, which we can support, but only thanks to the excellent scrutiny and expertise across all the parties in the other place and the six key amendments that have made a fundamental difference to what started off as, I am afraid, a fundamentally objectionable Bill. Members of the other place sought to compromise with the Government, but all too often that compromise was not forthcoming. It is unprecedented in my time here for the Government to suffer six defeats in a row on a Bill, as they did in the Lords. It is incredible that, after seven or eight years in the making, two abortive draft Bills, numerous consultations, the pre-legislative scrutiny Committee, and all this time under the responsibility of the same Minister, the Government still do not get it. After thousands of representations from mental health professionals, voluntary organisations, service users and the Mental Health Alliance, the Government still do not get it and are intent on trampling over all the good work and scrutiny done in the Lords by reversing all the amendments—despite all the public and press outcry over recent days.
	 The Observer last week carried an article with the heading:
	"Mentally ill deserve more than cynicism".
	The article continued:
	"A small minority of people who suffer from acute mental illness pose a threat to society. The overwhelming majority pose a threat only to themselves. All are equally deserving of compassionate treatment, but most are being failed by the National Health Service."
	Another article in  The Observer was headed:
	"Inside the violent, chaotic world of our mental wards".
	 The Times carried an article about under-18s being placed with the most dangerous patients. Lord Patel said:
	"If I was a parent of one of these children, I would be expecting not only this House, but the Government to take immediate and urgent action".
	 The Independent on Sunday yesterday carried the headline:
	"Insane! Stop the Mental Health Bill".
	I think it got the second line slightly wrong. Inside, a father reveals the suffering of his child on a secure adult ward.
	Yesterday Sheila Hollins, president of the Royal College of Psychiatrists and a deeply respected figure in mental health, said:
	"Overturning the Lords' amendments would be a grave mistake and deeply damaging to the future care and treatmentof mental health patients. The Government now has the opportunity to achieve mental health legislation which is ethical, principled and supported by patients, professionals, carers and families, and the public."
	Another article is entitled: "The vote for sanity." It goes on and on. These are not reactionary, right-wing publications. They are publications with a serious interest in mental health and, in particular, in patients and the families of patients who are suffering. I hope that the Government will not close their mind and their ears, but will listen to the many voices of reason that have echoed around this Chamber and the wider world in the last few weeks.
	Despite all that and the enormous amount of interest shown in the debate today—the first day back after the recess—the Government still do not get it, as was clear from the opening contribution from the Secretary of State, and want to return to their original Bill, which has been condemned as deeply stigmatising, as the latest attack on civil liberties, and as undermining the therapeutic relationship between clinician and patient. It is counter-productive in that it threatens to deter people with a mental illness from presenting in the first place, thereby driving mental illness underground, as many colleagues have said.

Tim Loughton: I will not, I am afraid, because I have very little time.
	Potentially, the most dangerous patient with a mental illness is the one whose condition deteriorates under the clinical radar. We are talking about people who have committed no offence, but just happen to be ill. So, despite all the Government's claims to the contrary, the measures that the Minister of State,the right hon. Member for Doncaster, Central(Ms Winterton), would have us revert to would not just prejudice the health of the patients, but could put at risk the safety of the public. So, the Government's position is not only arrogant and misinformed, but counter-productive and, perhaps, dangerous.
	The fact is that people in this country with a mental illness are being let down by a lack of not coercive powers, but prioritisation in the NHS and the Department of Health. There is an absence of a real champion for mental health in the Department. Whatever the Secretary of State says, mental health is the Cinderella service of the NHS. As many hon. Members, especially Labour Members, have said, services for children and young people are the Cinderella service of the Cinderella service. It is absolutely scandalous that one child a day is stillbeing placed in an adult ward. As the children's commissioner said, putting such vulnerable children in intimidating acute wards cannot have a therapeutic benefit. The report produced by his department was called "Pushed into the shadows".
	It is a scandal that mental health trusts are still bailing out other parts of the NHS with deficits. It is a scandal that the number of mental health beds has fallen by 20 per cent. since Labour came to power—in fact, the second largest fall has taken place in the Doncaster and South Humber Healthcare NHS Trust, which covers the constituency of the Minister of State. We are told by Louis Appleby that non-legislative options are being explored for dealing with children, which is why the amendments will be overturned. The Government have had seven years to address the matter, so when will we see results?
	It has already been stated that the Government's worst offence has been to pander to tabloid prejudices and ramp up the aura of dangerousness attached to mental illness.

Rosie Winterton: I am sorry that the hon. Member for East Worthing and Shoreham (Tim Loughton) ended a thoughtful and sometimes lively debate with a rather mean-minded speech. The debate has emphasised the importance of the Bill and its great sensitivity in dealing with the difficult matter of the law governing people who have a mental illness that has become so serious that they have to be detained, either for their own safety or for that of others.
	The figures are stark. Each year, 1,300 suicides and 50 homicides are committed by individuals who have had contact with mental health services. Today's debate has illustrated how controversial the subject is, and I am the first to admit that it is one on which it is difficult to find consensus, but after almost eight years of debate on reforming the current legislation, the Government have listened and compromised. I pay particular tribute to the work of the pre-legislative scrutiny Committee, which expressed concern about the length and complexity of the previous draft Bill, which is why we produced the much shorter amending Bill which is before the House today.
	It is important to see the Bill in the context of the much wider investment and inclusion policies that my right hon. Friend the Secretary of State mentioned in her opening speech. They include £1.5 billion more spent on mental health each year than was spent in 2001, 14,000 extra staff, 700 new community teams and a range of measures to improve inclusion in society of those with a mental illness. However, as well as improving services, it is important to make sure that our mental health legislation is updated and modernised. That is one of the points on which consensus has been reached.
	Those who have contributed to the debate have made several important points. The hon. Member forSouth Cambridgeshire (Mr. Lansley) acknowledged the increased investment and paid tribute to the staff,as did the hon. Member for East Worthing and Shoreham. I hope that they will support the amendments that we want to make to the Bill as it has emerged from the other place to restore the multidisciplinary approach. As the Bill stands, every decision will have to be referred back to doctors. The changes that we want to make have the support of Unison, the Royal College of Nursing and the British Psychological Society, so I hope that the hon. Gentlemen will join us in reversing the changes that were made in the other place.
	My right hon. Friend the Member for Sheffield, Brightside (Mr. Blunkett) spoke of the importance of advocacy and getting services right for young people. He paid particular tribute to the work of Jayne Zito and the need to ensure that victims have proper protection. I am sure that we will return to that in Committee to make sure that we do everything necessary to help victims.
	The hon. Member for North Norfolk (Norman Lamb) talked about issues relating to the black and minority ethnic communities. Through the "Delivering Race Equality" project, which we are undertaking now, it is important to ensure that there is no stigma or discrimination against people from BME communities.
	The hon. Member for Tiverton and Honiton (Angela Browning) spoke about autistic spectrum disorders and the Bournewood clauses. I know that she has a special interest in those subjects, and I am sure that we will return to them in Committee. I hope that she will be a member of the Committee.
	My hon. Friend the Member for Hendon (Mr. Dismore) referred to the points made by the Joint Committee on Human Rights, which he chairs. I have responded to him in a letter and we shall give those points further consideration.
	The hon. Member for Buckingham (John Bercow) normally makes extremely well considered speeches. He made several important points today and I shall refer to his comments about treatability, but I am concerned about his use of the phrase "catching people." The Bill is about getting treatment to people—not catching them, but ensuring that the people who need it get treatment.
	My hon. Friend the Member for Stafford (Mr. Kidney) talked about putting principles in the Bill. We returned to that issue, but it has been difficult to put principles in it, because it is an amending Bill. However, what we have done—we have reached agreement with the Opposition in the House of Lords on this—is make sure that the Bill refers to the factors that would be taken into account, in terms of the code of practice principles. I hope that when he looks at clause 10 he will realise that it addresses some of the issues that he raised. My hon. Friend the Member for Hackney, South and Shoreditch (Meg Hillier) gave a moving account of experiences in her constituency and made important points about advocacy. I know that she feels extremely strongly about the subject, and I am sure that we will return to it in Committee.
	The hon. Member for Caernarfon (Hywel Williams) talked about his professional experience and the situation in Wales, and my hon. Friend the Member for Rhondda (Chris Bryant) made a moving speech about his personal experiences. I understand that he is running the marathon for Mind, and I congratulate him on that. He talked particularly about exclusions, as did the hon. Member for Wyre Forest (Dr. Taylor). Many of the exclusions inserted in the other place have to do with culture and religion, but culture and religion are not mental disorders. That is why it is inappropriate for them to be exclusions. However, the issue of sexual deviancy was included in previous legislation. There were times when unmarried mothers who had babies were detained because that was felt to be a mental disorder, and homosexuality was considered a mental disorder, too. However, there have been issues around paedophilia, and that is why we need to remove the exclusion for sexual deviancy.
	The hon. Member for Windsor (Adam Afriyie) made a considered speech about stigma. My hon. Friend the Member for Stockport (Ann Coffey) made a number of points about local arrangements, and there are matters that we need to discuss in Committee about guidance that we can issue. The hon. Member for Cheltenham (Martin Horwood) spoke of his constituency case, and I have met the brother that he spoke about. The case illustrates some of the difficult issues that families face in such circumstances. My hon. Friend the Member for Bridgend (Mrs. Moon) acknowledged that the Bill is not about services, but about how important it is to take a multi-agency approach, and the importance of taking the views of carers into account.
	The hon. Member for Broxbourne (Mr. Walker) started off by making a thoughtful speech about stigma and Members of Parliament, but I was taken aback by the fact that he was derisory about an article in  The Daily Telegraph that said that if the Bill saved lives, people should vote for it. My hon. Friend the Member for Kingston upon Hull, North (Ms Johnson) talked about the nearest relatives, and that is an important subject that I am sure we will return to in Committee. The hon. Member for Rochford and Southend, East (James Duddridge) talked about his local trust, and the importance of people accessing services.
	My hon. Friend the Member for Denton and Reddish (Andrew Gwynne) talked about the importance of letting clinicians make decisions, and that is a significant point that I wish to address with regard to the general issues that have been raised, especially by Opposition Members. First, on the treatability test, it is without doubt true that the fact that the treatability test is in the Mental Health Act 1983 has prevented the development of certain services, particularly those for people with personality disorders, and has led to people being turned away from services. A woman came to see me as part of the Mental Health Alliance lobby, and the first thing that she said to me was "Rosie, I have a multiple personality disorder, and I keep being told that I can't be treated." We have to get rid of the treatability test to prevent people from being turned away.
	Baroness Corston, in her report on the Mental Health Bill, said that she welcomed getting rid of the treatability test because of the number of women who ended up in prison as a result of not being treatedfor personality disorders. The appropriate medical treatment test that we have inserted is stronger, because for the first time it gives legal status to the provision of appropriate and available medical treatment.
	Turning to supervised community treatment, many hon. Members asked for evidence of independent inquiries that had discussed the need for such treatment. The inquiry into John Barrett's treatment said:
	"In our view, the only means of securing John Barrett's compliance with treatment as an out-patient would have been a community treatment order, which is not available under the Mental Health Act."
	That is why we need to make sure that community treatment orders are available, not only to people who are a danger to others but to people who are a danger to themselves. We know from the evidence that we published last week that 56 people who committed suicide last year could well have been saved if they had received supervised community treatment. It is not right that the Lords amendments should say that someone should have two relapses before such treatment, as someone could have a history of voluntary in-patient non-compliance with treatment, so they should not be required to fulfil the same conditions as an out-patient.
	Finally, on impaired judgment, the examples that I am given most often are of young women with personality disorders who have suffered terrible emotional, physical and sexual abuse, but who do not have impaired judgment. If we deny those people treatment because we want to institute an impaired judgment test we would leave them to self-harm and sometimes suicide. It is important to remember, too, that some people have fluctuating capacity—they do not always have impaired judgment, but sometimes they do. If we want to tell people that they can refuse treatment for mental illness in the same way that people can refuse treatment for physical illness, we are making the decision as society, and saying, "It is fine for you to go away and commit suicide. We will take no action." We do not do so at the moment, but the impaired judgment test would allow that to happen. I do not believe that we as legislators should say that that is what we want to do.
	As I have said, this important debate has addressed a number of issues raised by right hon. and hon. Members. It has looked at the wider issues of inclusion and the way in which we make sure that a sensitive piece of legislation receives proper scrutiny in the House. I am not saying that it has not been difficult to achieve consensus on the Bill. It has not been easy all the time, but as a political commentator said in  The Daily Telegraph this morning, the issue before the House "could hardly be graver". As my right hon. Friend the Member for Sheffield, Brightside said, if we fail to act, we will let people down. Supervised community treatment is a vital part of the changes that we need to make, as is the removal of the current treatability test, which has meant that too many people, particularly those with personality disorders, have been turned away from treatment.
	To achieve those changes, we will ask the House to overturn some of the amendments made in the other place, but if the Opposition parties try to water down our proposals that will lead to some extremely vulnerable patients being denied treatment, and to an increased risk to public safety. I am sure that there will be a full and lively discussion in Committee, but I hope that the House will eventually agree that our proposals strike the right balance between patient safeguards and patient and public safety.
	 Question put and agreed to.
	 Bill accordingly read a Second time .

Motion made, and Question put forthwith, pursuantto Standing Order No. 119(9) (European Standing Committees),

Nadine Dorries: I have called for this debate today for a specific reason, and before I begin to wax lyrical about Bedfordshire in an attempt to attract the Minister to visit, I should explain why. Tourism in Bedfordshire supports 9,000 local jobs and contributes £465 million a year to the local economy. Tourism will be a key driver in moving our economy forward in the years ahead. Although the number of visitors arriving in Bedfordshire is on the increase, the amount that they are spending per visit is in decline, and we need to raise our game.
	Bedfordshire is a beautiful rural county. We have an engaging history—a rich tapestry of adventure and steadfast defiance, as reflected in some of the county's most famous sons such as the prison reformer John Howard, the anti-apartheid campaigner Archbishop Trevor Huddleston and, of course, the preacher and author of "The Pilgrim's Progress", the immortal tinker, John Bunyan, who was born in Elstow. All three of those famous Bedfordians have made such an impact during their time and beyond. I am sure that my Whip would concur that the fiercely independent spirit of these historical figures will live on in Bedfordshire for many years to come.
	We have a diversity of different cultures. Over hundreds of years, many people, including myself, have moved to Bedfordshire and chosen to make it their home, a process which was begun by the Danes more than 1,200 years ago. Since then, a huge variety of different communities and ethnic groups have settled in the county ranging from Moravians, Irish, Africans, Italians—there are many Italians—Bangladeshis, Poles, Indians and Pakistanis to name but a few. At the time of the last census, more than 74 different ethnic groups were represented in the county's schools alone. That richness in diversity gives the culture of Bedfordshire, and most notably the towns of Luton and Bedford, a vibrancy in terms of music, dance, food, language and fashion of which we can be justifiably proud. Luton international carnival is one of the largest carnivals in the country second only to Notting Hill carnival, and it attracts more than 160,000 visitors.
	It is our diverse and attractive landscape, our engaging history and our rich diversity of different cultures that makes Bedfordshire a truly a great place in which to live and work and which to visit. Last month, I took part in a tourism tour of Mid-Bedfordshire during the first British tourism week and visited much of what is on offer to the visitor. If safari parks were star rated, Woburn would be a solid five, and the Duke of Bedford is developing a reputation for only doing something if it is done properly. The new play ark at the safari park is a testament to that. The way in which the animals are kept, unsupervised, and viewed is exceptional. I lived in Africa for some time and visited several game parks. Woburn safari park looks just like the bush landscape in Luangwa valley, such is the attention to detail.
	In Woburn we also have the abbey, the deer park, the ridge, the shops, the walks, the lakes, the pubs—most notably my local, the Black Horse, where I am sure that my friends, Budge, Sue, Tom, Lottie, Jenny and Iain are all sat right now—the hotels, the tea shops and the rest that Woburn has to offer. I live in Woburn, and I would prefer it if no one came—I love it so much; it is so beautiful—but people have to work and live. We need to build on sustainable tourism that will provide jobs and encourage people not to travel long distances to work but to work in the area in which they live.
	On my tourism day, I visited Ampthill park, the former hunting ground of Henry VIII, where a monument marks the site at which Catherine of Aragon was kept under house arrest during her divorce. Catherine's cross will feature on my Christmas cards this year, with the sun right behind it at exactly12 midday, casting an aura around the cross. That was followed by a visit to Houghton house, the shell of a 17th century mansion recently restored by English Heritage and reputedly the inspiration for House Beautiful in John Bunyan's "Pilgrim's Progress". I moved on to Stondon motor museum, home to the UK's largest private collection of motor vehicles,with a life-size model of Captain Cook's ship, the Endeavour. The museum hosts many school tours. If classic cars are "your thing", Bedfordshire is the place to visit. We have Elstow abbey and Marston Vale forest, perfect for those who love cycling and now providing the Bedfordshire breakfast before people start at a reasonable cost.
	I have spoken only of what is on offer in my constituency. Bedfordshire has seven major tourist attractions, some of them world class, which between them secured 2.5 million visitors last year. I should mention Whipsnade wild animal park in Dunstable, located in the constituency of my hon. Friend the Member for South-West Bedfordshire (Andrew Selous).

Nadine Dorries: My hon. Friend makes an excellent point. I will go on to talk about how tourism can help to support the transport network in my constituency and in Bedfordshire as a whole.
	Despite these impressive attractions, there aremany more opportunities to increase the value and importance of the tourism industry to our local economy. As the tourism strategy for the county states, despite what we offer,
	"the tourism economy in Bedfordshire is not healthy."
	For example, over the past five years tourism earnings in the county have remained static, and there is an over-reliance on the daily visitor market. Business tourism is also underdeveloped, and Bedfordshire must significantly raise its game if we are to take full advantage of the exciting opportunities that this sector of the economy offers. While there has been some modest growth in the number of visitors to the area—11.2 million per year at the last count—average expenditure by those visitors has been declining in real terms, in stark contrast to the rest of the region and the country as a whole, where it has increased.
	As a Member of Parliament for a Bedfordshire constituency, it frequently frustrates me that even more people do not come to visit the county to explore and see what we have to offer. It is my ambition—shared with Bedfordshire county council, the district and borough councils, Bedfordshire and Luton economic development partnership, the East of England Development Agency and East of England Tourism—to achieve the following: we want more people to visit Bedfordshire, stay there for longer and spend more money there.
	Indeed, if the Under-Secretary has not already been to Bedfordshire, I strongly encourage him to visit soon. I would be delighted to show him the sights and would welcome the opportunity of treating him to lunch in the form of a Bedfordshire clanger. In essence, we need more people to visit, stay longer and spend more money while they are there.
	Why? The answer is simple: the growth of and greater investment in the tourist industry will have a variety of important benefits for local people and help drive the economy forward through additional inward investment. It will help to create more jobs. It will also help to support better facilities, especially in our rural areas. It will offer a wider range of events for local people and their friends and families to attend. It will also help to secure significant improvements in retail opportunities, the development of better transport links and other much needed infrastructure improvements, as my hon. Friend the Member for South-West Bedfordshire said.
	As more people visit Bedfordshire, local residents will value and appreciate more of what we have, which will help to establish greater civic pride among the local population. From a sustainable point of view, that will also help to reduce in-out commuting, which is already significant and on the rise.
	The 15-year tourism growth strategy, which the county-wide steering group presented, sets out what we need to achieve far more succinctly than I can. It states:
	"Bedfordshire will be recognised as places that have changed for the better. They will be known for their professionalism in hosting business visitors and in exploiting their location. Visitors will enjoy the variety of town and country, world-class attractions and events and their increased spending will support good quality local employment."
	That presents us with a great opportunity—and, indeed, a challenge—to secure the investment needed to achieve the many benefits that I mentioned a moment ago. That opportunity to make the most out of tourism for Bedfordshire—especially for local people—conveniently leads me to a proposal to locate a new Center Parcs village in Warren Wood, near Millbrook in my constituency.
	As the matter is currently subject to an appeal through the planning process, I do not expect the Under-Secretary to respond directly, but I would like to take the opportunity to reiterate the reasons for my support for the proposal and the significant benefits that I believe it will bring both to my constituency and the county as a whole.
	Center Parcs is, for some, among the most contentious of all the major issues in my constituency, and has attracted both supporters and protesters. Before I reached my opinion on the proposal, I listened to the views of a variety of people, such as local residents, parish and town councils, local councillors, as well as representatives of the local business community.
	I also visited the Centre Parcs Longleat village in Wiltshire, which, I noted from yesterday's edition of  Bedfordshire on Sunday, was also visited by its editor recently. I do not know whom the editor met during his visit, but when I was there, I insisted on meeting Center Parcs employees and suppliers, so that I could see the product on offer at first hand. I also spoke to local villagers adjacent to the Longleat site, who objected when the original application was first submitted.
	If Bedfordshire is to take full advantage and change its status from a "drive-through" county to a "drive-to" county, we need to show that we mean business. Center Parcs must not join the long list of "missed opportunities" for Bedfordshire. Our loss will be somebody else's gain. The location of Center Parcs would send out a strong and positive message about our determination and willingness to change.
	The creation of 1,400 new jobs—the equivalent of 900 full-time posts—will have a huge impact on the local economy and provide new opportunities for those seeking flexible employment, such as mothers with young families and others wanting to return to the workplace, in addition to a high number of managerial and skilled positions.
	Limits on time prevent me from listing in more detail the many benefits that Center Parcs would bring, but suffice it to say that I am confident that, if successful in its appeal, the location of Center Parcs in Bedfordshire would help to address some of the longer-term issues that have been hampering the ability of our visitor economy to expand, and significantly help raise the county's profile in a positive way, regionally and nationally.
	The 2012 London Olympic games also provide us with a once in a lifetime opportunity to help put Bedfordshire on the map. I would like to take the opportunity to encourage the Under-Secretary to do all that he can through his role to encourage the tourism industry in Bedfordshire. In particular, will he lobbyhis ministerial colleagues to ensure that Bedfordshire receives the necessary improvements to its infrastructure, including investment in better transport links? Will he also lobby his colleagues to ensure that Bedfordshire maximises its opportunities and potential in regard to the 2012 Olympics and addresses its infrastructure capacity?
	What reassurances can the Minister give me that Bedfordshire is high on his list for development as a tourist county? As John Bunyan famously said:
	"Words easy to be understood do often hit the mark; when high and learned ones do only pierce the air."
	I hope that the Minister will not disappoint.

Shaun Woodward: I congratulate the hon. Member for Mid-Bedfordshire (Mrs. Dorries) on securing this important debate. Mid-Bedfordshire is an important part of the tourist economy, and it was interesting to hear her note the importance of the area raising its game. It undoubtedly has significant potential to grow its visitor economy, and is capable of appealing to diverse tourism and visitor interests. It has a strong heritage and history, through its churches, country houses, villages, hamlets, market towns and many other visitor attractions. Indeed, I pay tribute to the hon. Lady, who made clear her commitment to British tourism week by visiting Woburn safari park, Ampthill park, Houghton house, Stondon motor museum, Marston Vale community forest centre, Elstow abbey, the moot hall and many other places too numerous to mention. This shows her commitment to the place that she has made her home and that she said that she had come to love.
	Tourism is an important part of the UK economy.It is our fifth largest industry and generated some£85 billion in turnover in 2005-06. It employs more than 2 million people, directly and indirectly. My Department is fully committed to supporting tourism and, in partnership with the industry and the wider public sector, we aim to maximise the growth and productivity of the sector. The Department invests more than £50 million a year through VisitBritain for overseas and domestic marketing and, across the UK, tourism now receives an estimated £311 million a year in public funding—more than ever before.
	Together with industry and the wider public sector, my Department has developed a clear, coherent policy framework for industry support and growth. This includes branding and marketing improvements led by VisitBritain, a new national skills strategy, work across Britain on driving up product quality through accommodation grading schemes, promoting investment including supporting better regulation, and the good practice guide on planning for tourism. Of course, better co-ordination of the £311 million a year is absolutely crucial. As the hon. Lady said, the 2012 Olympic and Paralympic games will present the tourism industry not only in Mid-Bedfordshire but across the whole of the UK with its greatest ever opportunity, with direct benefits that we estimate will be worth more than £2 billion.
	Since 2003, the responsibility has been passed to regional development authorities to deliver regional support for tourism. My Department and VisitBritain work closely with the RDAs to develop regional strategies and business support around marketing, skills, quality and, critically, sustainability. In that context, VisitBritain's funding agreement with my Department includes a commitment to promoting regional spreads of visitor expenditure outside London. This year, the DCMS will invest £3.6 million in the RDAs through strategic industry support, and £1.9 million in the Greater London authority to help to promote the capital's role as a gateway to the rest of the country.
	The East of England development agency andthe East of England tourism board have developed significant plans for tourism investment, focusingon strategic marketing, better intelligence, capacity building, product innovation and better skills. As the hon. Lady acknowledged, tourism is an important sector of the Bedfordshire economy, contributing some £465 million a year and supporting almost 10,000 jobs directly and indirectly. None the less, recent flat growth needs to be addressed.
	The hon. Member for South-West Bedfordshire (Andrew Selous) made an important point in principle about transport. Transport links are important, as is the recognition of the importance of tourism to the local economy. County councils have responsibility for some of these matters, however, and it is unfortunate to note that Bedfordshire county council reduced its spending from 2003-04 and again in 2004-05. I understand that its spending for 2005-06 now stands at zero. Mid-Bedfordshire's spending on tourism was reduced from £284,000 in 2003 to £251,000 in 2004, and was cut to £163,000 in 2005. I think that some local authorities do not recognise the importance of tourism to the local economy, and the amount that it contributes to jobs both directly and indirectly.
	However, a positive development is that both public and private-sector tourism stakeholders in Luton and Bedfordshire have put together a draft growth strategy for the long-term future of the area. In association with the county council, the Bedfordshire and Luton economic development partnership and industry, the East of England development agency is funding a tourism growth strategy for the county. A draft has been produced, and is currently out for consultation.
	The so-called sub-regional strategy is linked to broader regional objectives. They include developing a marketing strategy to increase the value of tourism to the Bedford and Luton economy and broaden the visitor base; agreeing on a programme of skills training and development for the area with People 1st and the Learning and Skills Council; working with the private sector in product innovation, particularly self-catering residential meeting facilities, events and "green" tourism; supporting Bedford and Luton regeneration and advising on how best to maximise development in the interests of attracting visitors; developing a compendium of base data and conducting regular visitor satisfaction and perception surveys to monitor progress; and establishing a tourism partnership with local authorities and business to disseminate information and best practice.

Shaun Woodward: I intend to publish the paper towards the end of June or the middle of July. As for the specific benefits for Mid-Bedfordshire, what mattersis participation by county councils, other local authorities, and indeed all partners. We are making available the opportunity that results from the United Kingdom's having won the competition to host the 2012 Olympic games. Having seen the benefits gained by Australia and Athens, we estimate that the UK is likely to benefit from at least £2 billion. It is certain that those who wish to benefit may do so, but they will need to develop their own strategies, tailor-made to their own communities. I am sure that, given the considerable list of visitor attractions that the hon. Lady managed to visit in just one week—tourism week—there are many attractions that could be open to visitors.
	It must be recognised that this is the greatest marketing opportunity that the UK tourism industry will ever enjoy. Some 4 billion of the world's population will view the Olympics and the run-up to them. Of course they will look at the sporting offer, but they will also look at what the UK offers the rest of the world. This is a country to visit not just for the Olympics but for our many other attractions. It is incumbent on the Government, having created the opportunity, to ensure that all attractions realise the potential for them all to benefit from the Olympics.
	It will be those who embrace the opportunity who do best. I am sure that the hon. Lady will wish to steer her local tourism industry to take advantage of that. A key priority has been to ensure that the benefits are spread across the country and we will work closely with the regional development agencies and local authorities to deliver this. Indeed regional business plans have been developed through the London Organising Committee of the Olympic Games' nations and regions groups including the East of England Development Agency's rising to the challenge programme.
	Bedfordshire is well placed to benefit. Its draft growth strategy is still at a relatively early stage,the attractiveness of its tourism offer and relative proximity to London give great potential for development as a destination.
	 Question put and agreed to.
	 Adjourned accordingly at twenty-seven minutes past Ten o'clock.